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Jan 8

Interactive Agents: Simulating Counselor-Client Psychological Counseling via Role-Playing LLM-to-LLM Interactions

Virtual counselors powered by large language models (LLMs) aim to create interactive support systems that effectively assist clients struggling with mental health challenges. To replicate counselor-client conversations, researchers have built an online mental health platform that allows professional counselors to provide clients with text-based counseling services for about an hour per session. Notwithstanding its effectiveness, challenges exist as human annotation is time-consuming, cost-intensive, privacy-protected, and not scalable. To address this issue and investigate the applicability of LLMs in psychological counseling conversation simulation, we propose a framework that employs two LLMs via role-playing for simulating counselor-client interactions. Our framework involves two LLMs, one acting as a client equipped with a specific and real-life user profile and the other playing the role of an experienced counselor, generating professional responses using integrative therapy techniques. We implement both the counselor and the client by zero-shot prompting the GPT-4 model. In order to assess the effectiveness of LLMs in simulating counselor-client interactions and understand the disparities between LLM- and human-generated conversations, we evaluate the synthetic data from various perspectives. We begin by assessing the client's performance through automatic evaluations. Next, we analyze and compare the disparities between dialogues generated by the LLM and those generated by professional counselors. Furthermore, we conduct extensive experiments to thoroughly examine the performance of our LLM-based counselor trained with synthetic interactive dialogues by benchmarking against state-of-the-art models for mental health.

  • 2 authors
·
Aug 28, 2024

We Care: Multimodal Depression Detection and Knowledge Infused Mental Health Therapeutic Response Generation

The detection of depression through non-verbal cues has gained significant attention. Previous research predominantly centred on identifying depression within the confines of controlled laboratory environments, often with the supervision of psychologists or counsellors. Unfortunately, datasets generated in such controlled settings may struggle to account for individual behaviours in real-life situations. In response to this limitation, we present the Extended D-vlog dataset, encompassing a collection of 1, 261 YouTube vlogs. Additionally, the emergence of large language models (LLMs) like GPT3.5, and GPT4 has sparked interest in their potential they can act like mental health professionals. Yet, the readiness of these LLM models to be used in real-life settings is still a concern as they can give wrong responses that can harm the users. We introduce a virtual agent serving as an initial contact for mental health patients, offering Cognitive Behavioral Therapy (CBT)-based responses. It comprises two core functions: 1. Identifying depression in individuals, and 2. Delivering CBT-based therapeutic responses. Our Mistral model achieved impressive scores of 70.1% and 30.9% for distortion assessment and classification, along with a Bert score of 88.7%. Moreover, utilizing the TVLT model on our Multimodal Extended D-vlog Dataset yielded outstanding results, with an impressive F1-score of 67.8%

  • 2 authors
·
Jun 15, 2024

Modeling Motivational Interviewing Strategies On An Online Peer-to-Peer Counseling Platform

Millions of people participate in online peer-to-peer support sessions, yet there has been little prior research on systematic psychology-based evaluations of fine-grained peer-counselor behavior in relation to client satisfaction. This paper seeks to bridge this gap by mapping peer-counselor chat-messages to motivational interviewing (MI) techniques. We annotate 14,797 utterances from 734 chat conversations using 17 MI techniques and introduce four new interviewing codes such as chit-chat and inappropriate to account for the unique conversational patterns observed on online platforms. We automate the process of labeling peer-counselor responses to MI techniques by fine-tuning large domain-specific language models and then use these automated measures to investigate the behavior of the peer counselors via correlational studies. Specifically, we study the impact of MI techniques on the conversation ratings to investigate the techniques that predict clients' satisfaction with their counseling sessions. When counselors use techniques such as reflection and affirmation, clients are more satisfied. Examining volunteer counselors' change in usage of techniques suggest that counselors learn to use more introduction and open questions as they gain experience. This work provides a deeper understanding of the use of motivational interviewing techniques on peer-to-peer counselor platforms and sheds light on how to build better training programs for volunteer counselors on online platforms.

  • 7 authors
·
Nov 9, 2022

PsyGUARD: An Automated System for Suicide Detection and Risk Assessment in Psychological Counseling

As awareness of mental health issues grows, online counseling support services are becoming increasingly prevalent worldwide. Detecting whether users express suicidal ideation in text-based counseling services is crucial for identifying and prioritizing at-risk individuals. However, the lack of domain-specific systems to facilitate fine-grained suicide detection and corresponding risk assessment in online counseling poses a significant challenge for automated crisis intervention aimed at suicide prevention. In this paper, we propose PsyGUARD, an automated system for detecting suicide ideation and assessing risk in psychological counseling. To achieve this, we first develop a detailed taxonomy for detecting suicide ideation based on foundational theories. We then curate a large-scale, high-quality dataset called PsySUICIDE for suicide detection. To evaluate the capabilities of automated systems in fine-grained suicide detection, we establish a range of baselines. Subsequently, to assist automated services in providing safe, helpful, and tailored responses for further assessment, we propose to build a suite of risk assessment frameworks. Our study not only provides an insightful analysis of the effectiveness of automated risk assessment systems based on fine-grained suicide detection but also highlights their potential to improve mental health services on online counseling platforms. Code, data, and models are available at https://github.com/qiuhuachuan/PsyGUARD.

  • 3 authors
·
Sep 30, 2024

PsychEval: A Multi-Session and Multi-Therapy Benchmark for High-Realism AI Psychological Counselor

To develop a reliable AI for psychological assessment, we introduce PsychEval, a multi-session, multi-therapy, and highly realistic benchmark designed to address three key challenges: 1) Can we train a highly realistic AI counselor? Realistic counseling is a longitudinal task requiring sustained memory and dynamic goal tracking. We propose a multi-session benchmark (spanning 6-10 sessions across three distinct stages) that demands critical capabilities such as memory continuity, adaptive reasoning, and longitudinal planning. The dataset is annotated with extensive professional skills, comprising over 677 meta-skills and 4577 atomic skills. 2) How to train a multi-therapy AI counselor? While existing models often focus on a single therapy, complex cases frequently require flexible strategies among various therapies. We construct a diverse dataset covering five therapeutic modalities (Psychodynamic, Behaviorism, CBT, Humanistic Existentialist, and Postmodernist) alongside an integrative therapy with a unified three-stage clinical framework across six core psychological topics. 3) How to systematically evaluate an AI counselor? We establish a holistic evaluation framework with 18 therapy-specific and therapy-shared metrics across Client-Level and Counselor-Level dimensions. To support this, we also construct over 2,000 diverse client profiles. Extensive experimental analysis fully validates the superior quality and clinical fidelity of our dataset. Crucially, PsychEval transcends static benchmarking to serve as a high-fidelity reinforcement learning environment that enables the self-evolutionary training of clinically responsible and adaptive AI counselors.

  • 13 authors
·
Jan 5

Do Large Language Models Align with Core Mental Health Counseling Competencies?

The rapid evolution of Large Language Models (LLMs) offers promising potential to alleviate the global scarcity of mental health professionals. However, LLMs' alignment with essential mental health counseling competencies remains understudied. We introduce CounselingBench, a novel NCMHCE-based benchmark evaluating LLMs across five key mental health counseling competencies. Testing 22 general-purpose and medical-finetuned LLMs, we find frontier models exceed minimum thresholds but fall short of expert-level performance, with significant variations: they excel in Intake, Assessment & Diagnosis yet struggle with Core Counseling Attributes and Professional Practice & Ethics. Medical LLMs surprisingly underperform generalist models accuracy-wise, while at the same time producing slightly higher-quality justifications but making more context-related errors. Our findings highlight the complexities of developing AI systems for mental health counseling, particularly for competencies requiring empathy and contextual understanding. We found that frontier LLMs perform at a level exceeding the minimal required level of aptitude for all key mental health counseling competencies, but fall short of expert-level performance, and that current medical LLMs do not significantly improve upon generalist models in mental health counseling competencies. This underscores the critical need for specialized, mental health counseling-specific fine-tuned LLMs that rigorously aligns with core competencies combined with appropriate human supervision before any responsible real-world deployment can be considered.

  • 11 authors
·
Oct 29, 2024

Therapy as an NLP Task: Psychologists' Comparison of LLMs and Human Peers in CBT

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

  • 4 authors
·
Sep 3, 2024

Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling

Large language models (LLMs) hold significant potential for mental health support, capable of generating empathetic responses and simulating therapeutic conversations. However, existing LLM-based approaches often lack the clinical grounding necessary for real-world psychological counseling, particularly in explicit diagnostic reasoning aligned with standards like the DSM/ICD and incorporating diverse therapeutic modalities beyond basic empathy or single strategies. To address these critical limitations, we propose PsyLLM, the first large language model designed to systematically integrate both diagnostic and therapeutic reasoning for mental health counseling. To develop the PsyLLM, we propose a novel automated data synthesis pipeline. This pipeline processes real-world mental health posts, generates multi-turn dialogue structures, and leverages LLMs guided by international diagnostic standards (e.g., DSM/ICD) and multiple therapeutic frameworks (e.g., CBT, ACT, psychodynamic) to simulate detailed clinical reasoning processes. Rigorous multi-dimensional filtering ensures the generation of high-quality, clinically aligned dialogue data. In addition, we introduce a new benchmark and evaluation protocol, assessing counseling quality across four key dimensions: comprehensiveness, professionalism, authenticity, and safety. Our experiments demonstrate that PsyLLM significantly outperforms state-of-the-art baseline models on this benchmark.

  • 8 authors
·
May 21, 2025

What Makes Digital Support Effective? How Therapeutic Skills Affect Clinical Well-Being

Online mental health support communities have grown in recent years for providing accessible mental and emotional health support through volunteer counselors. Despite millions of people participating in chat support on these platforms, the clinical effectiveness of these communities on mental health symptoms remains unknown. Furthermore, although volunteers receive some training based on established therapeutic skills studied in face-to-face environments such as active listening and motivational interviewing, it remains understudied how the usage of these skills in this online context affects people's mental health status. In our work, we collaborate with one of the largest online peer support platforms and use both natural language processing and machine learning techniques to measure how one-on-one support chats affect depression and anxiety symptoms. We measure how the techniques and characteristics of support providers, such as using affirmation, empathy, and past experience on the platform, affect support-seekers' mental health changes. We find that online peer support chats improve both depression and anxiety symptoms with a statistically significant but relatively small effect size. Additionally, support providers' techniques such as emphasizing the autonomy of the client lead to better mental health outcomes. However, we also found that some behaviors (e.g. persuading) are actually harmful to depression and anxiety outcomes. Our work provides key understanding for mental health care in the online setting and designing training systems for online support providers.

  • 7 authors
·
Dec 17, 2023

CharacterChat: Learning towards Conversational AI with Personalized Social Support

In our modern, fast-paced, and interconnected world, the importance of mental well-being has grown into a matter of great urgency. However, traditional methods such as Emotional Support Conversations (ESC) face challenges in effectively addressing a diverse range of individual personalities. In response, we introduce the Social Support Conversation (S2Conv) framework. It comprises a series of support agents and the interpersonal matching mechanism, linking individuals with persona-compatible virtual supporters. Utilizing persona decomposition based on the MBTI (Myers-Briggs Type Indicator), we have created the MBTI-1024 Bank, a group that of virtual characters with distinct profiles. Through improved role-playing prompts with behavior preset and dynamic memory, we facilitate the development of the MBTI-S2Conv dataset, which contains conversations between the characters in the MBTI-1024 Bank. Building upon these foundations, we present CharacterChat, a comprehensive S2Conv system, which includes a conversational model driven by personas and memories, along with an interpersonal matching plugin model that dispatches the optimal supporters from the MBTI-1024 Bank for individuals with specific personas. Empirical results indicate the remarkable efficacy of CharacterChat in providing personalized social support and highlight the substantial advantages derived from interpersonal matching. The source code is available in https://github.com/morecry/CharacterChat.

  • 8 authors
·
Aug 20, 2023

PsyLite Technical Report

With the rapid development of digital technology, AI-driven psychological counseling has gradually become an important research direction in the field of mental health. However, existing models still have deficiencies in dialogue safety, detailed scenario handling, and lightweight deployment. To address these issues, this study proposes PsyLite, a lightweight psychological counseling large language model agent developed based on the base model InternLM2.5-7B-chat. Through a two-stage training strategy (hybrid distillation data fine-tuning and ORPO preference optimization), PsyLite enhances the model's deep-reasoning ability, psychological counseling ability, and safe dialogue ability. After deployment using Ollama and Open WebUI, a custom workflow is created with Pipelines. An innovative conditional RAG is designed to introduce crosstalk humor elements at appropriate times during psychological counseling to enhance user experience and decline dangerous requests to strengthen dialogue safety. Evaluations show that PsyLite outperforms the baseline models in the Chinese general evaluation (CEval), psychological counseling professional evaluation (CPsyCounE), and dialogue safety evaluation (SafeDialBench), particularly in psychological counseling professionalism (CPsyCounE score improvement of 47.6\%) and dialogue safety ( score improvement of 2.4\%). Additionally, the model uses quantization technology (GGUF q4\_k\_m) to achieve low hardware deployment (5GB memory is sufficient for operation), providing a feasible solution for psychological counseling applications in resource-constrained environments.

  • 6 authors
·
Jun 26, 2025

TheraMind: A Strategic and Adaptive Agent for Longitudinal Psychological Counseling

Large language models (LLMs) in psychological counseling have attracted increasing attention. However, existing approaches often lack emotional understanding, adaptive strategies, and the use of therapeutic methods across multiple sessions with long-term memory, leaving them far from real clinical practice. To address these critical gaps, we introduce TheraMind, a strategic and adaptive agent for longitudinal psychological counseling. The cornerstone of TheraMind is a novel dual-loop architecture that decouples the complex counseling process into an Intra-Session Loop for tactical dialogue management and a Cross-Session Loop for strategic therapeutic planning. The Intra-Session Loop perceives the patient's emotional state to dynamically select response strategies while leveraging cross-session memory to ensure continuity. Crucially, the Cross-Session Loop empowers the agent with long-term adaptability by evaluating the efficacy of the applied therapy after each session and adjusting the method for subsequent interactions. We validate our approach in a high-fidelity simulation environment grounded in real clinical cases. Extensive evaluations show that TheraMind outperforms other methods, especially on multi-session metrics like Coherence, Flexibility, and Therapeutic Attunement, validating the effectiveness of its dual-loop design in emulating strategic, adaptive, and longitudinal therapeutic behavior. The code is publicly available at https://0mwwm0.github.io/TheraMind/.

  • 8 authors
·
Oct 29, 2025 1

Roleplaying with Structure: Synthetic Therapist-Client Conversation Generation from Questionnaires

The development of AI for mental health is hindered by a lack of authentic therapy dialogues, due to strict privacy regulations and the fact that clinical sessions were historically rarely recorded. We present an LLM-driven pipeline that generates synthetic counseling dialogues based on structured client profiles and psychological questionnaires. Grounded on the principles of Cognitive Behavioral Therapy (CBT), our method creates synthetic therapeutic conversations for clinical disorders such as anxiety and depression. Our framework, SQPsych (Structured Questionnaire-based Psychotherapy), converts structured psychological input into natural language dialogues through therapist-client simulations. Due to data governance policies and privacy restrictions prohibiting the transmission of clinical questionnaire data to third-party services, previous methodologies relying on proprietary models are infeasible in our setting. We address this limitation by generating a high-quality corpus using open-weight LLMs, validated through human expert evaluation and LLM-based assessments. Our SQPsychLLM models fine-tuned on SQPsychConv achieve strong performance on counseling benchmarks, surpassing baselines in key therapeutic skills. Our findings highlight the potential of synthetic data to enable scalable, data-secure, and clinically informed AI for mental health support. We will release our code, models, and corpus at https://ai-mh.github.io/SQPsych

  • 12 authors
·
Oct 29, 2025