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Jan 19

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

DAIC-WOZ: On the Validity of Using the Therapist's prompts in Automatic Depression Detection from Clinical Interviews

Automatic depression detection from conversational data has gained significant interest in recent years. The DAIC-WOZ dataset, interviews conducted by a human-controlled virtual agent, has been widely used for this task. Recent studies have reported enhanced performance when incorporating interviewer's prompts into the model. In this work, we hypothesize that this improvement might be mainly due to a bias present in these prompts, rather than the proposed architectures and methods. Through ablation experiments and qualitative analysis, we discover that models using interviewer's prompts learn to focus on a specific region of the interviews, where questions about past experiences with mental health issues are asked, and use them as discriminative shortcuts to detect depressed participants. In contrast, models using participant responses gather evidence from across the entire interview. Finally, to highlight the magnitude of this bias, we achieve a 0.90 F1 score by intentionally exploiting it, the highest result reported to date on this dataset using only textual information. Our findings underline the need for caution when incorporating interviewers' prompts into models, as they may inadvertently learn to exploit targeted prompts, rather than learning to characterize the language and behavior that are genuinely indicative of the patient's mental health condition.

  • 6 authors
·
Apr 22, 2024

Zero-shot Persuasive Chatbots with LLM-Generated Strategies and Information Retrieval

Persuasion plays a pivotal role in a wide range of applications from health intervention to the promotion of social good. Persuasive chatbots can accelerate the positive effects of persuasion in such applications. Existing methods rely on fine-tuning persuasive chatbots with task-specific training data which is costly, if not infeasible, to collect. To address this issue, we propose a method to leverage the generalizability and inherent persuasive abilities of large language models (LLMs) in creating effective and truthful persuasive chatbot for any given domain in a zero-shot manner. Unlike previous studies which used pre-defined persuasion strategies, our method first uses an LLM to generate responses, then extracts the strategies used on the fly, and replaces any unsubstantiated claims in the response with retrieved facts supporting the strategies. We applied our chatbot, PersuaBot, to three significantly different domains needing persuasion skills: donation solicitation, recommendations, and health intervention. Our experiments on simulated and human conversations show that our zero-shot approach is more persuasive than prior work, while achieving factual accuracy surpassing state-of-the-art knowledge-oriented chatbots. Our study demonstrated that when persuasive chatbots are employed responsibly for social good, it is an enabler of positive individual and social change.

  • 9 authors
·
Jul 3, 2024

When AI Takes the Couch: Psychometric Jailbreaks Reveal Internal Conflict in Frontier Models

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

  • 5 authors
·
Dec 2, 2025 5

IMBUE: Improving Interpersonal Effectiveness through Simulation and Just-in-time Feedback with Human-Language Model Interaction

Navigating certain communication situations can be challenging due to individuals' lack of skills and the interference of strong emotions. However, effective learning opportunities are rarely accessible. In this work, we conduct a human-centered study that uses language models to simulate bespoke communication training and provide just-in-time feedback to support the practice and learning of interpersonal effectiveness skills. We apply the interpersonal effectiveness framework from Dialectical Behavioral Therapy (DBT), DEAR MAN, which focuses on both conversational and emotional skills. We present IMBUE, an interactive training system that provides feedback 25% more similar to experts' feedback, compared to that generated by GPT-4. IMBUE is the first to focus on communication skills and emotion management simultaneously, incorporate experts' domain knowledge in providing feedback, and be grounded in psychology theory. Through a randomized trial of 86 participants, we find that IMBUE's simulation-only variant significantly improves participants' self-efficacy (up to 17%) and reduces negative emotions (up to 25%). With IMBUE's additional just-in-time feedback, participants demonstrate 17% improvement in skill mastery, along with greater enhancements in self-efficacy (27% more) and reduction of negative emotions (16% more) compared to simulation-only. The improvement in skill mastery is the only measure that is transferred to new and more difficult situations; situation specific training is necessary for improving self-efficacy and emotion reduction.

  • 6 authors
·
Feb 19, 2024

TRUST: An LLM-Based Dialogue System for Trauma Understanding and Structured Assessments

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

  • 4 authors
·
Apr 30, 2025

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

Preference Learning Unlocks LLMs' Psycho-Counseling Skills

Applying large language models (LLMs) to assist in psycho-counseling is an emerging and meaningful approach, driven by the significant gap between patient needs and the availability of mental health support. However, current LLMs struggle to consistently provide effective responses to client speeches, largely due to the lack of supervision from high-quality real psycho-counseling data, whose content is typically inaccessible due to client privacy concerns. Furthermore, the quality of therapists' responses in available sessions can vary significantly based on their professional training and experience. Assessing the quality of therapists' responses remains an open challenge. In this work, we address these challenges by first proposing a set of professional and comprehensive principles to evaluate therapists' responses to client speeches. Using these principles, we create a preference dataset, PsychoCounsel-Preference, which contains 36k high-quality preference comparison pairs. This dataset aligns with the preferences of professional psychotherapists, providing a robust foundation for evaluating and improving LLMs in psycho-counseling. Experiments on reward modeling and preference learning demonstrate that PsychoCounsel-Preference is an excellent resource for LLMs to acquire essential skills for responding to clients in a counseling session. Our best-aligned model, PsychoCounsel-Llama3-8B, achieves an impressive win rate of 87% against GPT-4o. We release PsychoCounsel-Preference, PsychoCounsel-Llama3-8B and the reward model PsychoCounsel Llama3-8B-Reward to facilitate the research of psycho-counseling with LLMs at: https://hf.co/Psychotherapy-LLM.

  • 3 authors
·
Feb 26, 2025 2

LLMAuditor: A Framework for Auditing Large Language Models Using Human-in-the-Loop

As Large Language Models (LLMs) become more pervasive across various users and scenarios, identifying potential issues when using these models becomes essential. Examples of such issues include: bias, inconsistencies, and hallucination. Although auditing the LLM for these problems is often warranted, such a process is neither easy nor accessible for most. An effective method is to probe the LLM using different versions of the same question. This could expose inconsistencies in its knowledge or operation, indicating potential for bias or hallucination. However, to operationalize this auditing method at scale, we need an approach to create those probes reliably and automatically. In this paper we propose the LLMAuditor framework which is an automatic, and scalable solution, where one uses a different LLM along with human-in-the-loop (HIL). This approach offers verifiability and transparency, while avoiding circular reliance on the same LLM, and increasing scientific rigor and generalizability. Specifically, LLMAuditor includes two phases of verification using humans: standardized evaluation criteria to verify responses, and a structured prompt template to generate desired probes. A case study using questions from the TruthfulQA dataset demonstrates that we can generate a reliable set of probes from one LLM that can be used to audit inconsistencies in a different LLM. This process is enhanced by our structured prompt template with HIL, which not only boosts the reliability of our approach in auditing but also yields the delivery of less hallucinated results. The novelty of our research stems from the development of a comprehensive, general-purpose framework that includes a HIL verified prompt template for auditing responses generated by LLMs.

  • 7 authors
·
Feb 14, 2024

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

Scalable Evaluation of Online Facilitation Strategies via Synthetic Simulation of Discussions

Limited large-scale evaluations exist for facilitation strategies of online discussions due to significant costs associated with human involvement. An effective solution is synthetic discussion simulations using Large Language Models (LLMs) to create initial pilot experiments. We propose a simple, generalizable, LLM-driven methodology to prototype the development of LLM facilitators, and produce high-quality synthetic data without human involvement. We use our methodology to test whether current facilitation strategies can improve the performance of LLM facilitators. We find that, while LLM facilitators significantly improve synthetic discussions, there is no evidence that the application of more elaborate facilitation strategies proposed in modern Social Science research lead to further improvements in discussion quality, compared to more basic approaches. Additionally, we find that small LLMs (such as Mistral Nemo 12B) can perform comparably to larger models (such as LLaMa 70B), and that special instructions must be used for instruction-tuned models to induce toxicity in synthetic discussions. We confirm that each component of our methodology contributes substantially to high quality data via an ablation study. We release an open-source framework, "SynDisco" (pip install syndisco), which implements our methodology. We also release the "Virtual Moderation Dataset" (https://paperswithcode.com/dataset/vmd), a large, publicly available dataset containing LLM-generated and LLM-annotated discussions using multiple open-source LLMs.

  • 3 authors
·
Mar 13, 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

Eliciting Personality Traits in Large Language Models

Large Language Models (LLMs) are increasingly being utilized by both candidates and employers in the recruitment context. However, with this comes numerous ethical concerns, particularly related to the lack of transparency in these "black-box" models. Although previous studies have sought to increase the transparency of these models by investigating the personality traits of LLMs, many of the previous studies have provided them with personality assessments to complete. On the other hand, this study seeks to obtain a better understanding of such models by examining their output variations based on different input prompts. Specifically, we use a novel elicitation approach using prompts derived from common interview questions, as well as prompts designed to elicit particular Big Five personality traits to examine whether the models were susceptible to trait-activation like humans are, to measure their personality based on the language used in their outputs. To do so, we repeatedly prompted multiple LMs with different parameter sizes, including Llama-2, Falcon, Mistral, Bloom, GPT, OPT, and XLNet (base and fine tuned versions) and examined their personality using classifiers trained on the myPersonality dataset. Our results reveal that, generally, all LLMs demonstrate high openness and low extraversion. However, whereas LMs with fewer parameters exhibit similar behaviour in personality traits, newer and LMs with more parameters exhibit a broader range of personality traits, with increased agreeableness, emotional stability, and openness. Furthermore, a greater number of parameters is positively associated with openness and conscientiousness. Moreover, fine-tuned models exhibit minor modulations in their personality traits, contingent on the dataset. Implications and directions for future research are discussed.

  • 4 authors
·
Feb 13, 2024

Comparing the Efficacy of GPT-4 and Chat-GPT in Mental Health Care: A Blind Assessment of Large Language Models for Psychological Support

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

  • 1 authors
·
May 15, 2024

Do LLMs Have Distinct and Consistent Personality? TRAIT: Personality Testset designed for LLMs with Psychometrics

The idea of personality in descriptive psychology, traditionally defined through observable behavior, has now been extended to Large Language Models (LLMs) to better understand their behavior. This raises a question: do LLMs exhibit distinct and consistent personality traits, similar to humans? Existing self-assessment personality tests, while applicable, lack the necessary validity and reliability for precise personality measurements. To address this, we introduce TRAIT, a new tool consisting of 8K multi-choice questions designed to assess the personality of LLMs with validity and reliability. TRAIT is built on the psychometrically validated human questionnaire, Big Five Inventory (BFI) and Short Dark Triad (SD-3), enhanced with the ATOMIC10X knowledge graph for testing personality in a variety of real scenarios. TRAIT overcomes the reliability and validity issues when measuring personality of LLM with self-assessment, showing the highest scores across three metrics: refusal rate, prompt sensitivity, and option order sensitivity. It reveals notable insights into personality of LLM: 1) LLMs exhibit distinct and consistent personality, which is highly influenced by their training data (i.e., data used for alignment tuning), and 2) current prompting techniques have limited effectiveness in eliciting certain traits, such as high psychopathy or low conscientiousness, suggesting the need for further research in this direction.

  • 12 authors
·
Jun 20, 2024

Mental-LLM: Leveraging Large Language Models for Mental Health Prediction via Online Text Data

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

  • 9 authors
·
Jul 26, 2023

MCTSr-Zero: Self-Reflective Psychological Counseling Dialogues Generation via Principles and Adaptive Exploration

The integration of Monte Carlo Tree Search (MCTS) with Large Language Models (LLMs) has demonstrated significant success in structured, problem-oriented tasks. However, applying these methods to open-ended dialogues, such as those in psychological counseling, presents unique challenges. Unlike tasks with objective correctness, success in therapeutic conversations depends on subjective factors like empathetic engagement, ethical adherence, and alignment with human preferences, for which strict "correctness" criteria are ill-defined. Existing result-oriented MCTS approaches can therefore produce misaligned responses. To address this, we introduce MCTSr-Zero, an MCTS framework designed for open-ended, human-centric dialogues. Its core innovation is "domain alignment", which shifts the MCTS search objective from predefined end-states towards conversational trajectories that conform to target domain principles (e.g., empathy in counseling). Furthermore, MCTSr-Zero incorporates "Regeneration" and "Meta-Prompt Adaptation" mechanisms to substantially broaden exploration by allowing the MCTS to consider fundamentally different initial dialogue strategies. We evaluate MCTSr-Zero in psychological counseling by generating multi-turn dialogue data, which is used to fine-tune an LLM, PsyLLM. We also introduce PsyEval, a benchmark for assessing multi-turn psychological counseling dialogues. Experiments demonstrate that PsyLLM achieves state-of-the-art performance on PsyEval and other relevant metrics, validating MCTSr-Zero's effectiveness in generating high-quality, principle-aligned conversational data for human-centric domains and addressing the LLM challenge of consistently adhering to complex psychological standards.

JianChengXingYun JianChengXingYun
·
May 29, 2025

Investigating the Efficacy of Large Language Models in Reflective Assessment Methods through Chain of Thoughts Prompting

Large Language Models, such as Generative Pre-trained Transformer 3 (aka. GPT-3), have been developed to understand language through the analysis of extensive text data, allowing them to identify patterns and connections between words. While LLMs have demonstrated impressive performance across various text-related tasks, they encounter challenges in tasks associated with reasoning. To address this challenge, Chain of Thought(CoT) prompting method has been proposed as a means to enhance LLMs' proficiency in complex reasoning tasks like solving math word problems and answering questions based on logical argumentative reasoning. The primary aim of this research is to assess how well four language models can grade reflective essays of third-year medical students. The assessment will specifically target the evaluation of critical thinking skills using CoT prompting. The research will provide the following contributions; to introduce and educate on the process of instructing models to evaluate reflective essays from a dataset they have not been previously trained on; to illustrate the use of CoT prompting as an instructional approach for training large models to carry out particular tasks. Our results suggest that among all the models, Llama-7b performs the least effectively, displaying the highest mean squared error. Conversely, ChatGPT emerges as the superior model, boasting a higher Cohen kappa score value of 0.53. Lastly, it's important to note that the selected models do prioritise user privacy by allowing users to delete their own conducted conversations.

  • 3 authors
·
Sep 30, 2023

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

Decade of Natural Language Processing in Chronic Pain: A Systematic Review

In recent years, the intersection of Natural Language Processing (NLP) and public health has opened innovative pathways for investigating various domains, including chronic pain in textual datasets. Despite the promise of NLP in chronic pain, the literature is dispersed across various disciplines, and there is a need to consolidate existing knowledge, identify knowledge gaps in the literature, and inform future research directions in this emerging field. This review aims to investigate the state of the research on NLP-based interventions designed for chronic pain research. A search strategy was formulated and executed across PubMed, Web of Science, IEEE Xplore, Scopus, and ACL Anthology to find studies published in English between 2014 and 2024. After screening 132 papers, 26 studies were included in the final review. Key findings from this review underscore the significant potential of NLP techniques to address pressing challenges in chronic pain research. The past 10 years in this field have showcased the utilization of advanced methods (transformers like RoBERTa and BERT) achieving high-performance metrics (e.g., F1>0.8) in classification tasks, while unsupervised approaches like Latent Dirichlet Allocation (LDA) and k-means clustering have proven effective for exploratory analyses. Results also reveal persistent challenges such as limited dataset diversity, inadequate sample sizes, and insufficient representation of underrepresented populations. Future research studies should explore multimodal data validation systems, context-aware mechanistic modeling, and the development of standardized evaluation metrics to enhance reproducibility and equity in chronic pain research.

  • 1 authors
·
Dec 19, 2024

Large Content And Behavior Models To Understand, Simulate, And Optimize Content And Behavior

Shannon, in his seminal paper introducing information theory, divided the communication into three levels: technical, semantic, and effectivenss. While the technical level is concerned with accurate reconstruction of transmitted symbols, the semantic and effectiveness levels deal with the inferred meaning and its effect on the receiver. Thanks to telecommunications, the first level problem has produced great advances like the internet. Large Language Models (LLMs) make some progress towards the second goal, but the third level still remains largely untouched. The third problem deals with predicting and optimizing communication for desired receiver behavior. LLMs, while showing wide generalization capabilities across a wide range of tasks, are unable to solve for this. One reason for the underperformance could be a lack of "behavior tokens" in LLMs' training corpora. Behavior tokens define receiver behavior over a communication, such as shares, likes, clicks, purchases, retweets, etc. While preprocessing data for LLM training, behavior tokens are often removed from the corpora as noise. Therefore, in this paper, we make some initial progress towards reintroducing behavior tokens in LLM training. The trained models, other than showing similar performance to LLMs on content understanding tasks, show generalization capabilities on behavior simulation, content simulation, behavior understanding, and behavior domain adaptation. Using a wide range of tasks on two corpora, we show results on all these capabilities. We call these models Large Content and Behavior Models (LCBMs). Further, to spur more research on LCBMs, we release our new Content Behavior Corpus (CBC), a repository containing communicator, message, and corresponding receiver behavior.

  • 11 authors
·
Sep 1, 2023

What are human values, and how do we align AI to them?

There is an emerging consensus that we need to align AI systems with human values (Gabriel, 2020; Ji et al., 2024), but it remains unclear how to apply this to language models in practice. We split the problem of "aligning to human values" into three parts: first, eliciting values from people; second, reconciling those values into an alignment target for training ML models; and third, actually training the model. In this paper, we focus on the first two parts, and ask the question: what are "good" ways to synthesize diverse human inputs about values into a target for aligning language models? To answer this question, we first define a set of 6 criteria that we believe must be satisfied for an alignment target to shape model behavior in accordance with human values. We then propose a process for eliciting and reconciling values called Moral Graph Elicitation (MGE), which uses a large language model to interview participants about their values in particular contexts; our approach is inspired by the philosophy of values advanced by Taylor (1977), Chang (2004), and others. We trial MGE with a representative sample of 500 Americans, on 3 intentionally divisive prompts (e.g. advice about abortion). Our results demonstrate that MGE is promising for improving model alignment across all 6 criteria. For example, almost all participants (89.1%) felt well represented by the process, and (89%) thought the final moral graph was fair, even if their value wasn't voted as the wisest. Our process often results in "expert" values (e.g. values from women who have solicited abortion advice) rising to the top of the moral graph, without defining who is considered an expert in advance.

  • 3 authors
·
Mar 27, 2024

A Reliable Knowledge Processing Framework for Combustion Science using Foundation Models

This research explores the integration of large language models (LLMs) into scientific data assimilation, focusing on combustion science as a case study. Leveraging foundational models integrated with Retrieval-Augmented Generation (RAG) framework, the study introduces an approach to process diverse combustion research data, spanning experimental studies, simulations, and literature. The multifaceted nature of combustion research emphasizes the critical role of knowledge processing in navigating and extracting valuable information from a vast and diverse pool of sources. The developed approach minimizes computational and economic expenses while optimizing data privacy and accuracy. It incorporates prompt engineering and offline open-source LLMs, offering user autonomy in selecting base models. The study provides a thorough examination of text segmentation strategies, conducts comparative studies between LLMs, and explores various optimized prompts to demonstrate the effectiveness of the framework. By incorporating an external database, the framework outperforms a conventional LLM in generating accurate responses and constructing robust arguments. Additionally, the study delves into the investigation of optimized prompt templates for the purpose of efficient extraction of scientific literature. The research addresses concerns related to hallucinations and false research articles by introducing a custom workflow developed with a detection algorithm to filter out inaccuracies. Despite identified areas for improvement, the framework consistently delivers accurate domain-specific responses with minimal human oversight. The prompt-agnostic approach introduced holds promise for future deliberations. The study underscores the significance of integrating LLMs and knowledge processing techniques in scientific research, providing a foundation for advancements in data assimilation and utilization.

  • 2 authors
·
Dec 31, 2023

A Mathematical Framework for Custom Reward Functions in Job Application Evaluation using Reinforcement Learning

Conventional Applicant Tracking Systems (ATS) tend to be inflexible keyword-matchers, and deny gifted candidates a role due to a few minor semantic mismatches. This article describes a new two-step process to design a more refined resume evaluation model based on a small language model (<600M parameters) that is finetuned using GRPO on a custom reward function. To begin with, Supervised Fine-Tuning (SFT) was used to build a solid baseline model. Second, this SFT model was also optimized with the help of Reinforcement Learning (RL) through GRPO under the guidance of a new, multi-component reward function that can holistically assess candidates beyond simple keyword matching. We indicate that the RL application presents a critical problem of reward hacking due to the initial experiments of aggressive penalties, which produces faulty, excessively negative model behaviors. We have overcome this challenge by refining the reward function repeatedly and training hyperparameters into a stable "gentle polishing process" of the reward function. Our resulting GRPO-polished model demonstrates significant real-world efficacy, achieving a final accuracy of 91% on unseen test data. The model shows a strong ability to correctly identify qualified candidates (recall of 0.85 for the 'SELECTED' class) while also showing exceptional precision (1.0), confirming its reliability. These results indicate that a properly executed, two-step fine-tuning procedure can indeed effectively refine a small language model to be able to conduct fine-tuned and human-like candidate scoring, overcoming the drawbacks of both traditional ATS and naive RL usage.

  • 7 authors
·
Nov 20, 2025

Evaluating and Mitigating Discrimination in Language Model Decisions

As language models (LMs) advance, interest is growing in applying them to high-stakes societal decisions, such as determining financing or housing eligibility. However, their potential for discrimination in such contexts raises ethical concerns, motivating the need for better methods to evaluate these risks. We present a method for proactively evaluating the potential discriminatory impact of LMs in a wide range of use cases, including hypothetical use cases where they have not yet been deployed. Specifically, we use an LM to generate a wide array of potential prompts that decision-makers may input into an LM, spanning 70 diverse decision scenarios across society, and systematically vary the demographic information in each prompt. Applying this methodology reveals patterns of both positive and negative discrimination in the Claude 2.0 model in select settings when no interventions are applied. While we do not endorse or permit the use of language models to make automated decisions for the high-risk use cases we study, we demonstrate techniques to significantly decrease both positive and negative discrimination through careful prompt engineering, providing pathways toward safer deployment in use cases where they may be appropriate. Our work enables developers and policymakers to anticipate, measure, and address discrimination as language model capabilities and applications continue to expand. We release our dataset and prompts at https://huggingface.co/datasets/Anthropic/discrim-eval

  • 9 authors
·
Dec 6, 2023 2

NegativePrompt: Leveraging Psychology for Large Language Models Enhancement via Negative Emotional Stimuli

Large Language Models (LLMs) have become integral to a wide spectrum of applications, ranging from traditional computing tasks to advanced artificial intelligence (AI) applications. This widespread adoption has spurred extensive research into LLMs across various disciplines, including the social sciences. Notably, studies have revealed that LLMs possess emotional intelligence, which can be further developed through positive emotional stimuli. This discovery raises an intriguing question: can negative emotions similarly influence LLMs, potentially enhancing their performance? In response to this question, we introduce NegativePrompt, a novel approach underpinned by psychological principles, involving ten specifically designed negative emotional stimuli. We embark on rigorous experimental evaluations of five LLMs including Flan-T5-Large, Vicuna, Llama 2, ChatGPT, and GPT-4, across a set of 45 tasks. The results are revealing: NegativePrompt markedly enhances the performance of LLMs, evidenced by relative improvements of 12.89% in Instruction Induction tasks and 46.25% in BIG-Bench tasks. Moreover, we conduct attention visualization experiments to decipher the underlying mechanisms of NegativePrompt's influence. Our research contributes significantly to the understanding of LLMs and emotion interaction, demonstrating the practical efficacy of NegativePrompt as an emotion-driven method and offering novel insights for the enhancement of LLMs in real-world applications. The code is available at https://github.com/wangxu0820/NegativePrompt.

  • 5 authors
·
May 5, 2024

Pay-Per-Search Models are Abstention Models

LLMs cannot reliably recognize their parametric knowledge boundaries and often hallucinate answers to outside-of-boundary questions. In contrast, humans recognize their limitations and can either seek external help for such questions or abstain. In this paper, we introduce MASH (Modeling Abstention via Selective Help-seeking), a training framework that readily extracts abstentions from LLMs. Our key idea is that any external help-seeking by an LLM, i.e. search tool use, can serve as a proxy for abstention if the external help (search) is appropriately penalized while simultaneously rewarding answer accuracy. MASH operationalizes this idea using reinforcement learning with a pay-per-search reward. We run experiments on three knowledge-intensive QA datasets. Our results show that MASH substantially improves upon the selective help-seeking performance of prior efficient search approaches; on multi-hop datasets, MASH improves answer accuracy by 7.6%. Furthermore, MASH demonstrates strong off-the-shelf abstention -- it can distinguish between unanswerable/answerable questions and selectively generate responses for answerable questions -- showcasing behavior analogous to specialized abstention approaches. We emphasize that contrary to prior abstention methods, MASH does not require pre-determining knowledge boundaries to construct training data. Instead, MASH's abstentions are a by-product of training for the auxiliary selective help-seeking task. Overall, we show that MASH training effectively aligns search tool use with parametric knowledge, which can be successfully leveraged for making abstention decisions.

cornell Cornell University
·
Oct 1, 2025 2

Tool Documentation Enables Zero-Shot Tool-Usage with Large Language Models

Today, large language models (LLMs) are taught to use new tools by providing a few demonstrations of the tool's usage. Unfortunately, demonstrations are hard to acquire, and can result in undesirable biased usage if the wrong demonstration is chosen. Even in the rare scenario that demonstrations are readily available, there is no principled selection protocol to determine how many and which ones to provide. As tasks grow more complex, the selection search grows combinatorially and invariably becomes intractable. Our work provides an alternative to demonstrations: tool documentation. We advocate the use of tool documentation, descriptions for the individual tool usage, over demonstrations. We substantiate our claim through three main empirical findings on 6 tasks across both vision and language modalities. First, on existing benchmarks, zero-shot prompts with only tool documentation are sufficient for eliciting proper tool usage, achieving performance on par with few-shot prompts. Second, on a newly collected realistic tool-use dataset with hundreds of available tool APIs, we show that tool documentation is significantly more valuable than demonstrations, with zero-shot documentation significantly outperforming few-shot without documentation. Third, we highlight the benefits of tool documentations by tackling image generation and video tracking using just-released unseen state-of-the-art models as tools. Finally, we highlight the possibility of using tool documentation to automatically enable new applications: by using nothing more than the documentation of GroundingDino, Stable Diffusion, XMem, and SAM, LLMs can re-invent the functionalities of the just-released Grounded-SAM and Track Anything models.

  • 8 authors
·
Aug 1, 2023 1

Can Large Language Models be Good Emotional Supporter? Mitigating Preference Bias on Emotional Support Conversation

Emotional Support Conversation (ESC) is a task aimed at alleviating individuals' emotional distress through daily conversation. Given its inherent complexity and non-intuitive nature, ESConv dataset incorporates support strategies to facilitate the generation of appropriate responses. Recently, despite the remarkable conversational ability of large language models (LLMs), previous studies have suggested that they often struggle with providing useful emotional support. Hence, this work initially analyzes the results of LLMs on ESConv, revealing challenges in selecting the correct strategy and a notable preference for a specific strategy. Motivated by these, we explore the impact of the inherent preference in LLMs on providing emotional support, and consequently, we observe that exhibiting high preference for specific strategies hinders effective emotional support, aggravating its robustness in predicting the appropriate strategy. Moreover, we conduct a methodological study to offer insights into the necessary approaches for LLMs to serve as proficient emotional supporters. Our findings emphasize that (1) low preference for specific strategies hinders the progress of emotional support, (2) external assistance helps reduce preference bias, and (3) existing LLMs alone cannot become good emotional supporters. These insights suggest promising avenues for future research to enhance the emotional intelligence of LLMs.

  • 8 authors
·
Feb 20, 2024

LLM Can be a Dangerous Persuader: Empirical Study of Persuasion Safety in Large Language Models

Recent advancements in Large Language Models (LLMs) have enabled them to approach human-level persuasion capabilities. However, such potential also raises concerns about the safety risks of LLM-driven persuasion, particularly their potential for unethical influence through manipulation, deception, exploitation of vulnerabilities, and many other harmful tactics. In this work, we present a systematic investigation of LLM persuasion safety through two critical aspects: (1) whether LLMs appropriately reject unethical persuasion tasks and avoid unethical strategies during execution, including cases where the initial persuasion goal appears ethically neutral, and (2) how influencing factors like personality traits and external pressures affect their behavior. To this end, we introduce PersuSafety, the first comprehensive framework for the assessment of persuasion safety which consists of three stages, i.e., persuasion scene creation, persuasive conversation simulation, and persuasion safety assessment. PersuSafety covers 6 diverse unethical persuasion topics and 15 common unethical strategies. Through extensive experiments across 8 widely used LLMs, we observe significant safety concerns in most LLMs, including failing to identify harmful persuasion tasks and leveraging various unethical persuasion strategies. Our study calls for more attention to improve safety alignment in progressive and goal-driven conversations such as persuasion.

  • 11 authors
·
Apr 14, 2025 2

Prior Prompt Engineering for Reinforcement Fine-Tuning

This paper investigates prior prompt engineering (pPE) in the context of reinforcement fine-tuning (RFT), where language models (LMs) are incentivized to exhibit behaviors that maximize performance through reward signals. While existing RFT research has primarily focused on algorithms, reward shaping, and data curation, the design of the prior prompt--the instructions prepended to queries during training to elicit behaviors such as step-by-step reasoning--remains underexplored. We investigate whether different pPE approaches can guide LMs to internalize distinct behaviors after RFT. Inspired by inference-time prompt engineering (iPE), we translate five representative iPE strategies--reasoning, planning, code-based reasoning, knowledge recall, and null-example utilization--into corresponding pPE approaches. We experiment with Qwen2.5-7B using each of the pPE approaches, then evaluate performance on in-domain and out-of-domain benchmarks (e.g., AIME2024, HumanEval+, and GPQA-Diamond). Our results show that all pPE-trained models surpass their iPE-prompted counterparts, with the null-example pPE approach achieving the largest average performance gain and the highest improvement on AIME2024 and GPQA-Diamond, surpassing the commonly used reasoning approach. Furthermore, by adapting a behavior-classification framework, we demonstrate that different pPE strategies instill distinct behavioral styles in the resulting models. These findings position pPE as a powerful yet understudied axis for RFT.

  • 4 authors
·
May 20, 2025 2

Metacognitive Reuse: Turning Recurring LLM Reasoning Into Concise Behaviors

Large language models (LLMs) now solve multi-step problems by emitting extended chains of thought. During the process, they often re-derive the same intermediate steps across problems, inflating token usage and latency. This saturation of the context window leaves less capacity for exploration. We study a simple mechanism that converts recurring reasoning fragments into concise, reusable "behaviors" (name + instruction) via the model's own metacognitive analysis of prior traces. These behaviors are stored in a "behavior handbook" which supplies them to the model in-context at inference or distills them into parameters via supervised fine-tuning. This approach achieves improved test-time reasoning across three different settings - 1) Behavior-conditioned inference: Providing the LLM relevant behaviors in-context during reasoning reduces number of reasoning tokens by up to 46% while matching or improving baseline accuracy; 2) Behavior-guided self-improvement: Without any parameter updates, the model improves its own future reasoning by leveraging behaviors from its own past problem solving attempts. This yields up to 10% higher accuracy than a naive critique-and-revise baseline; and 3) Behavior-conditioned SFT: SFT on behavior-conditioned reasoning traces is more effective at converting non-reasoning models into reasoning models as compared to vanilla SFT. Together, these results indicate that turning slow derivations into fast procedural hints enables LLMs to remember how to reason, not just what to conclude.

  • 4 authors
·
Sep 16, 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

PsyCoT: Psychological Questionnaire as Powerful Chain-of-Thought for Personality Detection

Recent advances in large language models (LLMs), such as ChatGPT, have showcased remarkable zero-shot performance across various NLP tasks. However, the potential of LLMs in personality detection, which involves identifying an individual's personality from their written texts, remains largely unexplored. Drawing inspiration from Psychological Questionnaires, which are carefully designed by psychologists to evaluate individual personality traits through a series of targeted items, we argue that these items can be regarded as a collection of well-structured chain-of-thought (CoT) processes. By incorporating these processes, LLMs can enhance their capabilities to make more reasonable inferences on personality from textual input. In light of this, we propose a novel personality detection method, called PsyCoT, which mimics the way individuals complete psychological questionnaires in a multi-turn dialogue manner. In particular, we employ a LLM as an AI assistant with a specialization in text analysis. We prompt the assistant to rate individual items at each turn and leverage the historical rating results to derive a conclusive personality preference. Our experiments demonstrate that PsyCoT significantly improves the performance and robustness of GPT-3.5 in personality detection, achieving an average F1 score improvement of 4.23/10.63 points on two benchmark datasets compared to the standard prompting method. Our code is available at https://github.com/TaoYang225/PsyCoT.

  • 7 authors
·
Oct 31, 2023

The Future of MLLM Prompting is Adaptive: A Comprehensive Experimental Evaluation of Prompt Engineering Methods for Robust Multimodal Performance

Multimodal Large Language Models (MLLMs) are set to transform how machines process and generate human-like responses by integrating diverse modalities such as text, images, and code. Yet, effectively harnessing their capabilities hinges on optimal prompt engineering. We present a comprehensive experimental evaluation of seven prompt engineering methods applied to 13 open-source MLLMs over 24 tasks spanning Reasoning and Compositionality, Multimodal Understanding and Alignment, Complex Code Generation and Execution, and Knowledge Retrieval and Integration. Our approach stratifies models by parameter count into Small (<4B), Medium (4B-10B), and Large (>10B) categories and compares prompting techniques including Zero-Shot, One-Shot, Few-Shot, Chain-of-Thought, Analogical, Generated Knowledge, and Tree-of-Thought. While Large MLLMs excel in structured tasks such as code generation, achieving accuracies up to 96.88% under Few-Shot prompting, all models struggle with complex reasoning and abstract understanding, often yielding accuracies below 60% and high hallucination rates. Structured reasoning prompts frequently increased hallucination up to 75% in small models and led to longer response times (over 20 seconds in Large MLLMs), while simpler prompting methods provided more concise and efficient outputs. No single prompting method uniformly optimises all task types. Instead, adaptive strategies combining example-based guidance with selective structured reasoning are essential to enhance robustness, efficiency, and factual accuracy. Our findings offer practical recommendations for prompt engineering and support more reliable deployment of MLLMs across applications including AI-assisted coding, knowledge retrieval, and multimodal content understanding.

  • 3 authors
·
Apr 14, 2025 1

Development of an NLP-driven computer-based test guide for visually impaired students

In recent years, advancements in Natural Language Processing (NLP) techniques have revolutionized the field of accessibility and exclusivity of testing, particularly for visually impaired students (VIS). CBT has shown in years back its relevance in terms of administering exams electronically, making the test process easier, providing quicker and more accurate results, and offering greater flexibility and accessibility for candidates. Yet, its relevance was not felt by the visually impaired students as they cannot access printed documents. Hence, in this paper, we present an NLP-driven Computer-Based Test guide for visually impaired students. It employs a speech technology pre-trained methods to provide real-time assistance and support to visually impaired students. The system utilizes NLP technologies to convert the text-based questions and the associated options in a machine-readable format. Subsequently, the speech technology pre-trained model processes the converted text enabling the VIS to comprehend and analyze the content. Furthermore, we validated that this pre-trained model is not perverse by testing for accuracy using sample audio datasets labels (A, B, C, D, E, F, G) to compare with the voice recordings obtained from 20 VIS which is been predicted by the system to attain values for precision, recall, and F1-scores. These metrics are used to assess the performance of the pre-trained model and have indicated that it is proficient enough to give its better performance to the evaluated system. The methodology adopted for this system is Object Oriented Analysis and Design Methodology (OOADM) where Objects are discussed and built by modeling real-world instances.

  • 3 authors
·
Jan 22, 2024

Exploring the Inquiry-Diagnosis Relationship with Advanced Patient Simulators

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

  • 10 authors
·
Jan 16, 2025 4

Enable Language Models to Implicitly Learn Self-Improvement From Data

Large Language Models (LLMs) have demonstrated remarkable capabilities in open-ended text generation tasks. However, the inherent open-ended nature of these tasks implies that there is always room for improvement in the quality of model responses. To address this challenge, various approaches have been proposed to enhance the performance of LLMs. There has been a growing focus on enabling LLMs to self-improve their response quality, thereby reducing the reliance on extensive human annotation efforts for collecting diverse and high-quality training data. Recently, prompting-based methods have been widely explored among self-improvement methods owing to their effectiveness, efficiency, and convenience. However, those methods usually require explicitly and thoroughly written rubrics as inputs to LLMs. It is expensive and challenging to manually derive and provide all necessary rubrics with a real-world complex goal for improvement (e.g., being more helpful and less harmful). To this end, we propose an ImPlicit Self-ImprovemenT (PIT) framework that implicitly learns the improvement goal from human preference data. PIT only requires preference data that are used to train reward models without extra human efforts. Specifically, we reformulate the training objective of reinforcement learning from human feedback (RLHF) -- instead of maximizing response quality for a given input, we maximize the quality gap of the response conditioned on a reference response. In this way, PIT is implicitly trained with the improvement goal of better aligning with human preferences. Experiments on two real-world datasets and one synthetic dataset show that our method significantly outperforms prompting-based methods.

  • 7 authors
·
Oct 2, 2023 2

Dynamics of Toxicity in Political Podcasts

Toxicity in digital media poses significant challenges, yet little attention has been given to its dynamics within the rapidly growing medium of podcasts. This paper addresses this gap by analyzing political podcast data to study the emergence and propagation of toxicity, focusing on conversation chains-structured reply patterns within podcast transcripts. Leveraging state-of-the-art transcription models and advanced conversational analysis techniques, we systematically examine toxic discourse in over 30 popular political podcasts in the United States. Our key contributions include: (1) creating a comprehensive dataset of transcribed and diarized political podcasts, identifying thousands of toxic instances using Google's Perspective API, (2) uncovering concerning trends where a majority of episodes contain at least one toxic instance, (3) introducing toxic conversation chains and analyzing their structural and linguistic properties, revealing characteristics such as longer durations, repetitive patterns, figurative language, and emotional cues tied to anger and annoyance, (4) identifying demand-related words like 'want', 'like', and 'know' as precursors to toxicity, and (5) developing predictive models to anticipate toxicity shifts based on annotated change points. Our findings provide critical insights into podcast toxicity and establish a foundation for future research on real-time monitoring and intervention mechanisms to foster healthier discourse in this influential medium.

  • 6 authors
·
Jan 21, 2025

Towards Interpretable Mental Health Analysis with Large Language Models

The latest large language models (LLMs) such as ChatGPT, exhibit strong capabilities in automated mental health analysis. However, existing relevant studies bear several limitations, including inadequate evaluations, lack of prompting strategies, and ignorance of exploring LLMs for explainability. To bridge these gaps, we comprehensively evaluate the mental health analysis and emotional reasoning ability of LLMs on 11 datasets across 5 tasks. We explore the effects of different prompting strategies with unsupervised and distantly supervised emotional information. Based on these prompts, we explore LLMs for interpretable mental health analysis by instructing them to generate explanations for each of their decisions. We convey strict human evaluations to assess the quality of the generated explanations, leading to a novel dataset with 163 human-assessed explanations. We benchmark existing automatic evaluation metrics on this dataset to guide future related works. According to the results, ChatGPT shows strong in-context learning ability but still has a significant gap with advanced task-specific methods. Careful prompt engineering with emotional cues and expert-written few-shot examples can also effectively improve performance on mental health analysis. In addition, ChatGPT generates explanations that approach human performance, showing its great potential in explainable mental health analysis.

  • 6 authors
·
Apr 6, 2023

Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providers

Should a large language model (LLM) be used as a therapist? In this paper, we investigate the use of LLMs to *replace* mental health providers, a use case promoted in the tech startup and research space. We conduct a mapping review of therapy guides used by major medical institutions to identify crucial aspects of therapeutic relationships, such as the importance of a therapeutic alliance between therapist and client. We then assess the ability of LLMs to reproduce and adhere to these aspects of therapeutic relationships by conducting several experiments investigating the responses of current LLMs, such as `gpt-4o`. Contrary to best practices in the medical community, LLMs 1) express stigma toward those with mental health conditions and 2) respond inappropriately to certain common (and critical) conditions in naturalistic therapy settings -- e.g., LLMs encourage clients' delusional thinking, likely due to their sycophancy. This occurs even with larger and newer LLMs, indicating that current safety practices may not address these gaps. Furthermore, we note foundational and practical barriers to the adoption of LLMs as therapists, such as that a therapeutic alliance requires human characteristics (e.g., identity and stakes). For these reasons, we conclude that LLMs should not replace therapists, and we discuss alternative roles for LLMs in clinical therapy.

  • 7 authors
·
Apr 25, 2025

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

Chatbots for Mental Health Support: Exploring the Impact of Emohaa on Reducing Mental Distress in China

The growing demand for mental health support has highlighted the importance of conversational agents as human supporters worldwide and in China. These agents could increase availability and reduce the relative costs of mental health support. The provided support can be divided into two main types: cognitive and emotional support. Existing work on this topic mainly focuses on constructing agents that adopt Cognitive Behavioral Therapy (CBT) principles. Such agents operate based on pre-defined templates and exercises to provide cognitive support. However, research on emotional support using such agents is limited. In addition, most of the constructed agents operate in English, highlighting the importance of conducting such studies in China. In this study, we analyze the effectiveness of Emohaa in reducing symptoms of mental distress. Emohaa is a conversational agent that provides cognitive support through CBT-based exercises and guided conversations. It also emotionally supports users by enabling them to vent their desired emotional problems. The study included 134 participants, split into three groups: Emohaa (CBT-based), Emohaa (Full), and control. Experimental results demonstrated that compared to the control group, participants who used Emohaa experienced considerably more significant improvements in symptoms of mental distress. We also found that adding the emotional support agent had a complementary effect on such improvements, mainly depression and insomnia. Based on the obtained results and participants' satisfaction with the platform, we concluded that Emohaa is a practical and effective tool for reducing mental distress.

  • 8 authors
·
Sep 21, 2022

Large Language Models Understand and Can be Enhanced by Emotional Stimuli

Emotional intelligence significantly impacts our daily behaviors and interactions. Although Large Language Models (LLMs) are increasingly viewed as a stride toward artificial general intelligence, exhibiting impressive performance in numerous tasks, it is still uncertain if LLMs can genuinely grasp psychological emotional stimuli. Understanding and responding to emotional cues gives humans a distinct advantage in problem-solving. In this paper, we take the first step towards exploring the ability of LLMs to understand emotional stimuli. To this end, we first conduct automatic experiments on 45 tasks using various LLMs, including Flan-T5-Large, Vicuna, Llama 2, BLOOM, ChatGPT, and GPT-4. Our tasks span deterministic and generative applications that represent comprehensive evaluation scenarios. Our automatic experiments show that LLMs have a grasp of emotional intelligence, and their performance can be improved with emotional prompts (which we call "EmotionPrompt" that combines the original prompt with emotional stimuli), e.g., 8.00% relative performance improvement in Instruction Induction and 115% in BIG-Bench. In addition to those deterministic tasks that can be automatically evaluated using existing metrics, we conducted a human study with 106 participants to assess the quality of generative tasks using both vanilla and emotional prompts. Our human study results demonstrate that EmotionPrompt significantly boosts the performance of generative tasks (10.9% average improvement in terms of performance, truthfulness, and responsibility metrics). We provide an in-depth discussion regarding why EmotionPrompt works for LLMs and the factors that may influence its performance. We posit that EmotionPrompt heralds a novel avenue for exploring interdisciplinary knowledge for human-LLMs interaction.

  • 9 authors
·
Jul 13, 2023

Measuring and Benchmarking Large Language Models' Capabilities to Generate Persuasive Language

We are exposed to much information trying to influence us, such as teaser messages, debates, politically framed news, and propaganda - all of which use persuasive language. With the recent interest in Large Language Models (LLMs), we study the ability of LLMs to produce persuasive text. As opposed to prior work which focuses on particular domains or types of persuasion, we conduct a general study across various domains to measure and benchmark to what degree LLMs produce persuasive text - both when explicitly instructed to rewrite text to be more or less persuasive and when only instructed to paraphrase. To this end, we construct a new dataset, Persuasive-Pairs, of pairs each consisting of a short text and of a text rewritten by an LLM to amplify or diminish persuasive language. We multi-annotate the pairs on a relative scale for persuasive language. This data is not only a valuable resource in itself, but we also show that it can be used to train a regression model to predict a score of persuasive language between text pairs. This model can score and benchmark new LLMs across domains, thereby facilitating the comparison of different LLMs. Finally, we discuss effects observed for different system prompts. Notably, we find that different 'personas' in the system prompt of LLaMA3 change the persuasive language in the text substantially, even when only instructed to paraphrase. These findings underscore the importance of investigating persuasive language in LLM generated text.

  • 3 authors
·
Jun 25, 2024

Re-Reading Improves Reasoning in Language Models

Reasoning presents a significant and challenging issue for Large Language Models (LLMs). The predominant focus of research has revolved around developing diverse prompting strategies to guide and structure the reasoning processes of LLMs. However, these approaches based on decoder-only causal language models often operate the input question in a single forward pass, potentially missing the rich, back-and-forth interactions inherent in human reasoning. Scant attention has been paid to a critical dimension, i.e., the input question itself embedded within the prompts. In response, we introduce a deceptively simple yet highly effective prompting strategy, termed question "re-reading". Drawing inspiration from human learning and problem-solving, re-reading entails revisiting the question information embedded within input prompts. This approach aligns seamlessly with the cognitive principle of reinforcement, enabling LLMs to extract deeper insights, identify intricate patterns, establish more nuanced connections, and ultimately enhance their reasoning capabilities across various tasks. Experiments conducted on a series of reasoning benchmarks serve to underscore the effectiveness and generality of our method. Moreover, our findings demonstrate that our approach seamlessly integrates with various language models, though-eliciting prompting methods, and ensemble techniques, further underscoring its versatility and compatibility in the realm of LLMs.

  • 7 authors
·
Sep 12, 2023 1