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Rachel Kornfield

Publications and source records attributed to Rachel Kornfield.

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Designing for the Moment: How One-Minute Interventions Fit or Falter Across Domains

This paper explores the design space for one-minute digital interventions that prompt immediate action without onboarding or sensing. By embracing Fogg's Behavior Model and four design principles informed by literature, the goal of these interventions was to provide triggers that encourage actions so simple that even people with low motivation would be willing to complete them. We examined the utility of these prompts by conducting a 14-day study with 22 participants interested in making small lifestyle improvements in at least one of three domains: physical activity, healthy eating, and mental well-being. When combined with insights drawn from participants' rewrites of our prompts, our findings suggest that intentional personalization through co-authorship could be a lightweight personalization mechanism that balances relevance with low friction.

cs.HC

The Agony of Opacity: Foundations for Reflective Interpretability in AI-Mediated Mental Health Support

Throughout history, a prevailing paradigm in mental healthcare has been one in which distressed people may receive treatment with little understanding around how their experience is perceived by their care provider, and in turn, the decisions made by their provider around how treatment will progress. Paralleling this offline model of care, people who seek mental health support from artificial intelligence (AI)-based chatbots are similarly provided little context for how their expressions of distress are processed by the model, and subsequently, any reasoning or theoretical grounding that may underlie model responses. People in severe distress who turn to AI chatbots for support thus find themselves caught between black boxes, contending with unique forms of agony that arise from these intersecting opacities. In this paper, we argue that the distinct psychological state of individuals experiencing severe mental distress uniquely necessitates a higher standard of end-user interpretability in comparison to general AI chatbot use. We propose a reflective interpretability approach to AI-mediated mental health support, which nudges users to engage in an agency-preserving and iterative process of reflection and interpretation of model outputs, towards creating meaning from interactions (rather than accepting outputs as directive instructions). Drawing on interpretability practices from four mental health fields (psychotherapy, crisis intervention, psychiatry, and care authorization), we describe concrete design approaches for reflective interpretability in AI-mediated mental health support, including role induction, prosocial advance directives, intervention titration, and well-defined mechanisms for recourse, alongside a discussion of potential risks and mitigation measures.

cs.HC

Perfectly to a Tee: Understanding User Perceptions of Personalized LLM-Enhanced Narrative Interventions

Stories about overcoming personal struggles can effectively illustrate the application of psychological theories in real life, yet they may fail to resonate with individuals' experiences. In this work, we employ large language models (LLMs) to create tailored narratives that acknowledge and address unique challenging thoughts and situations faced by individuals. Our study, involving 346 young adults across two settings, demonstrates that personalized LLM-enhanced stories were perceived to be better than human-written ones in conveying key takeaways, promoting reflection, and reducing belief in negative thoughts. These stories were not only seen as more relatable but also similarly authentic to human-written ones, highlighting the potential of LLMs in helping young adults manage their struggles. The findings of this work provide crucial design considerations for future narrative-based digital mental health interventions, such as the need to maintain relatability without veering into implausibility and refining the wording and tone of AI-enhanced content.

cs.HC

When Testing AI Tests Us: Safeguarding Mental Health on the Digital Frontlines

Red-teaming is a core part of the infrastructure that ensures that AI models do not produce harmful content. Unlike past technologies, the black box nature of generative AI systems necessitates a uniquely interactional mode of testing, one in which individuals on red teams actively interact with the system, leveraging natural language to simulate malicious actors and solicit harmful outputs. This interactional labor done by red teams can result in mental health harms that are uniquely tied to the adversarial engagement strategies necessary to effectively red team. The importance of ensuring that generative AI models do not propagate societal or individual harm is widely recognized -- one less visible foundation of end-to-end AI safety is also the protection of the mental health and wellbeing of those who work to keep model outputs safe. In this paper, we argue that the unmet mental health needs of AI red-teamers is a critical workplace safety concern. Through analyzing the unique mental health impacts associated with the labor done by red teams, we propose potential individual and organizational strategies that could be used to meet these needs, and safeguard the mental health of red-teamers. We develop our proposed strategies through drawing parallels between common red-teaming practices and interactional labor common to other professions (including actors, mental health professionals, conflict photographers, and content moderators), describing how individuals and organizations within these professional spaces safeguard their mental health given similar psychological demands. Drawing on these protective practices, we describe how safeguards could be adapted for the distinct mental health challenges experienced by red teaming organizations as they mitigate emerging technological risks on the new digital frontlines.

cs.CY

Investigating the Role of Situational Disruptors in Engagement with Digital Mental Health Tools

Challenges in engagement with digital mental health (DMH) tools are commonly addressed through technical enhancements and algorithmic interventions. This paper shifts the focus towards the role of users' broader social context as a significant factor in engagement. Through an eight-week text messaging program aimed at enhancing psychological wellbeing, we recruited 20 participants to help us identify situational engagement disruptors (SEDs), including personal responsibilities, professional obligations, and unexpected health issues. In follow-up design workshops with 25 participants, we explored potential solutions that address such SEDs: prioritizing self-care through structured goal-setting, alternative framings for disengagement, and utilization of external resources. Our findings challenge conventional perspectives on engagement and offer actionable design implications for future DMH tools.

cs.HC

Large Language Model Agents for Improving Engagement with Behavior Change Interventions: Application to Digital Mindfulness

Although engagement in self-directed wellness exercises typically declines over time, integrating social support such as coaching can sustain it. However, traditional forms of support are often inaccessible due to the high costs and complex coordination. Large Language Models (LLMs) show promise in providing human-like dialogues that could emulate social support. Yet, in-depth, in situ investigations of LLMs to support behavior change remain underexplored. We conducted two randomized experiments to assess the impact of LLM agents on user engagement with mindfulness exercises. First, a single-session study, involved 502 crowdworkers; second, a three-week study, included 54 participants. We explored two types of LLM agents: one providing information and another facilitating self-reflection. Both agents enhanced users' intentions to practice mindfulness. However, only the information-providing LLM, featuring a friendly persona, significantly improved engagement with the exercises. Our findings suggest that specific LLM agents may bridge the social support gap in digital health interventions.

cs.HC

Understanding the Role of Large Language Models in Personalizing and Scaffolding Strategies to Combat Academic Procrastination

Traditional interventions for academic procrastination often fail to capture the nuanced, individual-specific factors that underlie them. Large language models (LLMs) hold immense potential for addressing this gap by permitting open-ended inputs, including the ability to customize interventions to individuals' unique needs. However, user expectations and potential limitations of LLMs in this context remain underexplored. To address this, we conducted interviews and focus group discussions with 15 university students and 6 experts, during which a technology probe for generating personalized advice for managing procrastination was presented. Our results highlight the necessity for LLMs to provide structured, deadline-oriented steps and enhanced user support mechanisms. Additionally, our results surface the need for an adaptive approach to questioning based on factors like busyness. These findings offer crucial design implications for the development of LLM-based tools for managing procrastination while cautioning the use of LLMs for therapeutic guidance.

cs.HC

Using Adaptive Bandit Experiments to Increase and Investigate Engagement in Mental Health

Digital mental health (DMH) interventions, such as text-message-based lessons and activities, offer immense potential for accessible mental health support. While these interventions can be effective, real-world experimental testing can further enhance their design and impact. Adaptive experimentation, utilizing algorithms like Thompson Sampling for (contextual) multi-armed bandit (MAB) problems, can lead to continuous improvement and personalization. However, it remains unclear when these algorithms can simultaneously increase user experience rewards and facilitate appropriate data collection for social-behavioral scientists to analyze with sufficient statistical confidence. Although a growing body of research addresses the practical and statistical aspects of MAB and other adaptive algorithms, further exploration is needed to assess their impact across diverse real-world contexts. This paper presents a software system developed over two years that allows text-messaging intervention components to be adapted using bandit and other algorithms while collecting data for side-by-side comparison with traditional uniform random non-adaptive experiments. We evaluate the system by deploying a text-message-based DMH intervention to 1100 users, recruited through a large mental health non-profit organization, and share the path forward for deploying this system at scale. This system not only enables applications in mental health but could also serve as a model testbed for adaptive experimentation algorithms in other domains.

cs.AI