Script-Strategy Aligned Generation: Aligning LLMs with Expert-Crafted Dialogue Scripts and Therapeutic Strategies for PsychotherapyChatbots or conversational agents (CAs) are increasingly used to improve access to digital psychotherapy. Many current systems rely on rigid, rule-based designs, heavily dependent on expert-crafted dialogue scripts for guiding therapeutic conversations. Although advances in large language models (LLMs) offer potential for more flexible interactions, their lack of controllability and explanability poses challenges in psychotherapy. In this work, we explored how aligning LLMs with expert-crafted scripts can enhance psychotherapeutic chatbot performance. Our comparative Study 1 showed that LLMs aligned with expert-crafted scripts through prompting and fine-tuning significantly outperformed both pure LLMs and rule-based chatbots, achieving an effective balance between dialogue flexibility and adherence to therapeutic principles. Building on findings, we proposed ``Script-Strategy Aligned Generation (SSAG)'', a more flexible alignment approach that reduces reliance on fully scripted content while maintaining LLMs' therapeutic adherence and controllability. In a 10-day field Study 2, SSAG demonstrated performance comparable to full script alignment, empirically supporting SSAG as an efficient approach for aligning LLMs with domain expertise. Our work advances LLM applications in psychotherapy by providing a controllable and scalable solution, reducing reliance on expert effort. It also provides a collaborative framework for domain experts and developers to efficiently build expertise-aligned chatbots, broadening access to broader context of psychotherapy.2025XSXin Sun et al.Facilitating Support and BelongingCSCW
Mano: Designing for Tactile Experiences in Advanced Dementia CareProfessional caregivers want to provide feelings of security and comfort to people with dementia in advanced care, but limited resources frequently restrict professional caregivers from doing so. One potential solution to make social, non-verbal connections with people in advanced dementia care is the use of artifacts that offer comfort and stimulating tactile experiences. In this study, we explored the role of two design artifacts, the Mano Quilt, a weighted blanket, and the Mano Fold, a foldable pillow, in supporting caregivers to increase feelings of comfort and security in people with advanced dementia through warmth. In a field study, we collected data through observations of 26 residents with dementia who interacted with the two artifacts and 17 interviews with their formal caregivers in three care organizations. We reveal which aesthetic and material qualities evoke haptic and bodily experiences such as presence, comfort, and activity and how the artifacts support existing caregiving practices. We encourage future researchers to design to enrich the senses as an aesthetic experience and provide emotional support and companionship to increase well-being for people with advanced dementia.2025SBSanne Beijer et al.Eindhoven University of Technology, Department of Industrial DesignHaptic WearablesElderly Care & Dementia SupportCHI
Open-ended Play For People With DementiaThe progression of dementia leads to a loss of initiative and agency, halting daily activities, hobbies, or social encounters. Open-ended play can encourage initiative but remains underexplored in demen- tia. This paper explores how technology-driven design can support open-ended play, making social interactions more enjoyable and re- newing interest in daily activities. We conducted five workshops at dementia daycare facilities, observing people with dementia engage with playful circuit-building toolkits to identify strategies. Find- ings reveal these toolkits stimulated self-direction and initiative to accomplish self-imposed goals, both independently and collabora- tively. We show how open-ended play fosters confidence, resilience, social engagement, and self-expression, allowing people with de- mentia to exercise choice and share moments of achievement. We provide design implications for technology to stimulate initiative through open-ended play by 1) balancing structure and freedom, 2) emphasizing novelty and material diversity for non-verbal social connection, and 3) considering age-appropriate aesthetics.2025AVAlicia Valencia et al.TU/e, Industrial DesignSerious & Functional GamesElderly Care & Dementia SupportCHI
Challenging Futures: Using Chatbots to Reflect on Aging and DementiaIntertemporal reflection, flexibly thinking forward and backward in time, is vital for one's future planning. Yet, cultivating intertemporal reflection about encountering difficult futures, e.g., developing a progressive cognitive condition like dementia, can be challenging. We assessed people's attitudes towards dementia following conversing with a chatbot presented as either neurotypical or simulating dementia symptoms. While neither the chatbot’s presentation nor the framing of participants’ future selves impacted attitudes toward dementia, it influenced participants' experiences. When framed as future selves, the chatbot evoked a strong emotional connection, leading to reflection on aging, particularly with the chatbot simulating dementia symptoms. Participants interacting with the chatbot framed as a stranger with simulated symptoms often felt frustrated, especially when they had a task-oriented mindset. Chatbots can be promising tools for prompting reflections on challenging futures, such as dementia, although their effectiveness varies due to the tensions between simulated cognitive decline and expectations for effective communication.2025RKRucha Khot et al.Eindhoven University of Technology, Industrial DesignAugmentative & Alternative Communication (AAC)Mental Health Apps & Online Support CommunitiesEmpowerment of Marginalized GroupsCHI
Models of (Often) Ambivalent Robot Stereotypes: Content, Structure, and Predictors of Robots' Age and Gender StereotypesThis study focused on investigating the content, structure, and predictors of robots' stereotypes. We involved 120 participants in an online study and asked them to rate 80 robots on communion, agency, suitability for female and suitability for male tasks. In line with the stereotype content model, we discovered that robots' stereotypes are described by two dimensions, communion and agency, which combine to form univalent (e.g., low communion/low agency), as well as ambivalent clusters (e.g., low communion/high agency). Moreover, we found out that a robot’s stereotypical appearance has a role in activating stereotypes. Indeed, in our study, female robots featuring appearance cues socio-culturally associated with femininity (e.g., eyelashes or apparel) were perceived as more communal, and juvenile robots featuring appearance cues tapping into the baby schema (e.g., cartoony eyes) were perceived as more communal, less agentic, and less suited to perform tasks. Given the renowned relationship between stereotyping, prejudice and discrimination, the causal link between appearance and stereotyping we establish in this paper can help HRI researchers disentangle the relation between robots' design and people's behavioral tendencies towards them, including proneness to harm.2023GPGiulia Perugia et al.Social Robot InteractionAlgorithmic Fairness & BiasGender & Race Issues in HCIHRI
Online Proctoring: Privacy Invasion or Study Alleviation? Discovering Acceptability Using Contextual IntegrityDetecting fraud during online exams using proctoring software comes with substantial privacy challenges. Previous work argues students experience heightened anxiety and have privacy concerns. However, little is known about which specific aspects of online proctoring cause these concerns. This study contributes such insights by using the Contextual Integrity (CI) framework to discover how students (N = 456) rate the acceptability of 1064 proctoring information flows with varying information types, recipients, and transmission principles. We find that the acceptability varies considerably depending on the context. Besides exposing obvious privacy violations, we find that, under certain conditions, students consider it acceptable to share data with teachers - despite their lack of involvement in proctoring. Also, the acceptability of sharing highly sensitive information - which should under no circumstances be shared - sometimes increases. We discuss the implications of these and other findings and provide concrete recommendations for educational institutions using online proctoring.2023ATArnout Terpstra et al.Tilburg Institute of Law, Technology & Society, SURFPrivacy by Design & User ControlPrivacy Perception & Decision-MakingCHI
LivingMoments: Bespoke Social Communication for People living with Dementia and their RelativesDementia can hinder a person's ability to engage with their relatives. Existing communication technologies do not support people with dementia in maintaining social contact since they are not designed for their abilities and needs. This paper presents LivingMoments, a communication system that enables the engagement of people with dementia with their relatives. The system uses digital and physical interaction design considering people's different and changing abilities. Over a six-week field evaluation of LivingMoments, involving six participants living at home with different levels of dementia, we collected qualitative and quantitative data about the experiences of them and their relatives. Based on the data analysis, we found the need to adapt communication to individual abilities, lowering barriers through content calibration and establishing habits for continuous use. We evinced a set of design considerations for technologies to support a lasting engagement of people with dementia with different and changing abilities.2022MTMyrte Thoolen et al.University of Technology EindhovenElderly Care & Dementia SupportAging-in-Place Assistance SystemsCHI
Designing for Everyday Sounds at Home with People with Dementia and their PartnersPeople with dementia and their caregivers aging in place have expressed the need for social, emotional, and recreational interventions at home. Listening to everyday sounds evokes memories and provides conversational cues to support social relations and elicit emotional responses for people with dementia. However, research has yet to explore how these meaningful experiences can be transferred into home settings. This paper presents the insights from our co-design study that involved three people with dementia and their partners in developing an interactive sound player for listening to everyday sounds at home. We report on the motivations of people with dementia and their caregivers to engage in meaningful sound-based activities at home and present the Tumbler as a prototype to foster initiative and agency in exploring familiar everyday sounds. We present design implications of how sound can enrich the everyday experiences of dementia by facilitating social and pleasurable moments at home.2022MHMaarten Houben et al.Eindhoven University of Technology, Tilburg UniversityElderly Care & Dementia SupportAging-in-Place Assistance SystemsCHI
Using Self-Determination Theory in Social Robots to Increase Motivation in L2 Word LearningThis study presents a second language word learning experiment using a social robot with motivational strategies. These strategies were implemented in a social robot tutor to stimulate preschool children’s intrinsic motivation. Subsequently, we investigated their effect on children’s task engagement and word learning performance. The strategies were derived from the Self-Determination Theory, a well-known psychological theory that assumes that intrinsic motivation is strongly related to the fulfillment of three basic human needs, namely the need for autonomy, competence, and relatedness. We found an increase in the strength and duration of task engagement when all three psychological needs were supported by the robot. However, no significant results for learning gains were observed. Our intervention appears a promising method for improving child-robot interactions in educational settings, especially to sustain in long-term interactions.2020PMPeggy van Minkelen et al.Collaborative Learning & Peer TeachingRobots in Education & HealthcareHRI
Varied Human-Like Gestures for Social Robots: Investigating the Effects on Children's Engagement and Language LearningTo investigate whether a humanoid robot’s use of gestures improves children’s learning of second language vocabulary, and if variation in gestures strengthens this effect, we conducted a field study where a total of 94 children (aged 4–6 years old) played a language learning game with a NAO robot. The robot either used no gestures at all, repeated the same gesture every time a target word was presented, or produced a different gesture for each occurrence of a target word. We found that, contrary to what the majority of existing research suggests, the robot’s use of gestures did not result in increased learning outcomes, compared to a robot that did not use gestures. However, engagement between child and robot was higher in both the repeated and varied gesture conditions, compared to the condition without gestures. An exploratory analysis showed that age played a role: the older children in the study learned more than the younger children when the robot used gestures. It is therefore important to carefully consider the design and application of robot gestures to support the learning process. The contribution of this work is twofold: it is a conceptual reproduction of a previous study, and we have taken first steps towards exploring the role of variation in gestures. The study was preregistered, and all materials are made publicly available.2020JWJan de Wit et al.Special Education TechnologySocial Robot InteractionHRI
Makers in Healthcare: The Role of Occupational Therapists in the Design of DIY Assistive TechnologyAdvancements in personal fabrication technologies (e.g. 3D printing) resulted in a rising interest in 'do-it-yourself assistive technology' (DIY AT). Clinical knowledge is considered fundamental for DIY AT design, but research into making DIY AT by clinicians is limited. In this paper, we explore occupational therapists' attitudes towards 3D printing both before and after gaining hands-on experience with 3D modelling software. In addition, as clinicians indicate to prefer collaborations with experienced designers, we organized a codesign study with occupational therapists and professional designers to conceptualize a feasible collaborative DIY-AT design process. The results of our studies show an overall enthusiasm of occupational therapists towards 3D printing, but the perceived impact of 3D printing on their job performance decreased after gaining hands-on experience. Collaborating with designers seems a viable way forward. We propose a model for a collaborative design process, highlighting different phases and the roles that occupational therapists and designers play.2020KSKarin Slegers et al.Tilburg University & KU LeuvenRobots in Education & HealthcareDesktop 3D Printing & Personal FabricationCHI
The Role of Everyday Sounds in Advanced Dementia CareThe representation of sounds derived from everyday life can be beneficial for people with dementia by evoking memories and emotional responses. Despite this potential, integrating sound and sound-based interventions in care facilities has not received much research attention. In this paper, we present the findings from a field study that explored the responses of 19 people with advanced dementia to a selection of everyday sounds presented to them in a care home and the role of these responses in the care environment. To study this, we deployed Vita, a 'pillow-like' sound player, in two dementia care facilities for four weeks, during which observations were recorded. Afterwards, we conducted interviews with caregivers who used Vita in everyday care practice. Our findings reveal how everyday sounds provided by Vita stimulated meaningful conversation, playfulness, and connection between residents and caregivers. Furthermore, we propose design implications for integrating everyday sounds in dementia care.2020MHMaarten Houben et al.Eindhoven University of Technology & Tilburg UniversityElderly Care & Dementia SupportCHI