Virtual Counselor Extenders: Social Cue Taxonomy, Soft Rooms, and Brief Motivational Interviewing

To address behavioral health shortages, we propose virtual counselor extenders: socially interactive virtual health agents (VHAs) that operationalize evidence-based interventions to expand clinicians’ reach and mitigate barriers to access for stigmatized populations. Current VHAs often lack systematic therapeutic communication and evidence-based environmental design. We present five contributions: (1) the implementation of a complete Brief Motivational Interviewing (BMI) intervention for heavy-drinking adults; (2) the application of a social cue taxonomy to systematically document multimodal active listening behaviors; (3) the design of a therapeutic ”soft room” grounded in environmental psychology; (4) a quantitative evaluation of usability and engagement with the target population; and (5) a qualitative thematic analysis of user acceptance regarding agent demographics and environmental realism. We conclude by extending the taxonomy with therapeutic-specific cues and providing design recommendations for future virtual counseling systems. This work demonstrates that autonomous agents can deliver complex therapeutic interventions while maintaining high user acceptance.