Daily Papers

Mental health has increasingly become a global issue that reveals the limitations of traditional conversational psychotherapy, constrained by location, time, expense, and privacy concerns. In response to these challenges, we introduce SoulSpeak, a Large Language Model (LLM)-enabled chatbot designed to democratize access to psychotherapy. SoulSpeak improves upon the capabilities of standard LLM-enabled chatbots by incorporating a novel dual-memory component that combines short-term and long-term context via Retrieval Augmented Generation (RAG) to offer personalized responses while ensuring the preservation of user privacy and intimacy through a dedicated privacy module. In addition, it leverages a counseling chat dataset of therapist-client interactions and various prompting techniques to align the generated responses with psychotherapeutic methods. We introduce two fine-tuned BERT models to evaluate the system against existing LLMs and human therapists: the Conversational Psychotherapy Preference Model (CPPM) to simulate human preference among responses and another to assess response relevance to user input. CPPM is useful for training and evaluating psychotherapy-focused language models independent from SoulSpeak, helping with the constrained resources available for psychotherapy. Furthermore, the effectiveness of the dual-memory component and the robustness of the privacy module are also examined. Our findings highlight the potential and challenge of enhancing mental health care by offering an alternative that combines the expertise of traditional therapy with the advantages of LLMs, providing a promising way to address the accessibility and personalization gap in current mental health services.

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.

Psychotherapy or counseling is typically conducted through spoken conversation between a therapist and a client. Analyzing the speech characteristics of psychotherapeutic interactions can help understand the factors associated with effective psychotherapy. This paper introduces CUEMPATHY, a large-scale speech dataset collected from actual counseling sessions. The dataset consists of 156 counseling sessions involving 39 therapist-client dyads. The process of speech data collection, subjective ratings (one observer and two client ratings), and transcription are described. An automatic speech and text processing system is developed to locate the time stamps of speaker turns in each session. Examining the relationships among the three subjective ratings suggests that observer and client ratings have no significant correlation, while the client-rated measures are significantly correlated. The intensity similarity between the therapist and the client, measured by the averaged absolute difference of speaker-turn-level intensities, is associated with the psychotherapy outcomes. Recent studies on the acoustic and linguistic characteristics of the CUEMPATHY are introduced.

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.

This study explores the use of Large language models to analyze therapist remarks in a psychotherapeutic setting. The paper focuses on the application of BERTopic, a machine learning-based topic modeling tool, to the dialogue of two different groups of therapists (classical and modern), which makes it possible to identify and describe a set of topics that consistently emerge across these groups. The paper describes in detail the chosen algorithm for BERTopic, which included creating a vector space from a corpus of therapist remarks, reducing its dimensionality, clustering the space, and creating and optimizing topic representation. Along with the automatic topical modeling by the BERTopic, the research involved an expert assessment of the findings and manual topic structure optimization. The topic modeling results highlighted the most common and stable topics in therapists speech, offering insights into how language patterns in therapy develop and remain stable across different therapeutic styles. This work contributes to the growing field of machine learning in psychotherapy by demonstrating the potential of automated methods to improve both the practice and training of therapists. The study highlights the value of topic modeling as a tool for gaining a deeper understanding of therapeutic dialogue and offers new opportunities for improving therapeutic effectiveness and clinical supervision.

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.

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.

There is a significant gap between patient needs and available mental health support today. In this paper, we aim to thoroughly examine the potential of using Large Language Models (LLMs) to assist professional psychotherapy. To this end, we propose a new benchmark, CBT-BENCH, for the systematic evaluation of cognitive behavioral therapy (CBT) assistance. We include three levels of tasks in CBT-BENCH: I: Basic CBT knowledge acquisition, with the task of multiple-choice questions; II: Cognitive model understanding, with the tasks of cognitive distortion classification, primary core belief classification, and fine-grained core belief classification; III: Therapeutic response generation, with the task of generating responses to patient speech in CBT therapy sessions. These tasks encompass key aspects of CBT that could potentially be enhanced through AI assistance, while also outlining a hierarchy of capability requirements, ranging from basic knowledge recitation to engaging in real therapeutic conversations. We evaluated representative LLMs on our benchmark. Experimental results indicate that while LLMs perform well in reciting CBT knowledge, they fall short in complex real-world scenarios requiring deep analysis of patients' cognitive structures and generating effective responses, suggesting potential future work.

Using large language models (LLMs) to assist psychological counseling is a significant but challenging task at present. Attempts have been made on improving empathetic conversations or acting as effective assistants in the treatment with LLMs. However, the existing datasets lack consulting knowledge, resulting in LLMs lacking professional consulting competence. Moreover, how to automatically evaluate multi-turn dialogues within the counseling process remains an understudied area. To bridge the gap, we propose CPsyCoun, a report-based multi-turn dialogue reconstruction and evaluation framework for Chinese psychological counseling. To fully exploit psychological counseling reports, a two-phase approach is devised to construct high-quality dialogues while a comprehensive evaluation benchmark is developed for the effective automatic evaluation of multi-turn psychological consultations. Competitive experimental results demonstrate the effectiveness of our proposed framework in psychological counseling. We open-source the datasets and model for future research at https://github.com/CAS-SIAT-XinHai/CPsyCoun

Large language models (LLMs) have demonstrated notable advancements in psychological counseling. However, existing models generally do not explicitly model seekers' emotion shifts across counseling sessions, a core focus in classical psychological schools. Moreover, how to align counselor models' responses with these emotion shifts while proactively mitigating safety risks remains underexplored. To bridge these gaps, we propose PsychēChat, which explicitly integrates emotion shift tracking and safety risk analysis for psychological counseling. Specifically, we employ interactive role-playing to synthesize counselor--seeker dialogues, incorporating two modules: Emotion Management Module, to capture seekers' current emotions and emotion shifts; and Risk Control Module, to anticipate seekers' subsequent reactions and identify potential risks. Furthermore, we introduce two modeling paradigms. The Agent Mode structures emotion management, risk control, and counselor responses into a collaborative multi-agent pipeline. The LLM Mode integrates these stages into a unified chain-of-thought for end-to-end inference, balancing efficiency and performance. Extensive experiments, including interactive scoring, dialogue-level evaluation, and human assessment, demonstrate that PsychēChat outperforms existing methods for emotional insight and safety control.

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

People experiencing severe distress increasingly use Large Language Model (LLM) chatbots as mental health support tools. Discussions on social media have described how engagements were lifesaving for some, but evidence suggests that general-purpose LLM chatbots also have notable risks that could endanger the welfare of users if not designed responsibly. In this study, we investigate the lived experiences of people who have used LLM chatbots for mental health support. We build on interviews with 21 individuals from globally diverse backgrounds to analyze how users create unique support roles for their chatbots, fill in gaps in everyday care, and navigate associated cultural limitations when seeking support from chatbots. We ground our analysis in psychotherapy literature around effective support, and introduce the concept of therapeutic alignment, or aligning AI with therapeutic values for mental health contexts. Our study offers recommendations for how designers can approach the ethical and effective use of LLM chatbots and other AI mental health support tools in mental health care.

Recently, the demand for psychological counseling has significantly increased as more individuals express concerns about their mental health. This surge has accelerated efforts to improve the accessibility of counseling by using large language models (LLMs) as counselors. To ensure client privacy, training open-source LLMs faces a key challenge: the absence of realistic counseling datasets. To address this, we introduce Cactus, a multi-turn dialogue dataset that emulates real-life interactions using the goal-oriented and structured approach of Cognitive Behavioral Therapy (CBT). We create a diverse and realistic dataset by designing clients with varied, specific personas, and having counselors systematically apply CBT techniques in their interactions. To assess the quality of our data, we benchmark against established psychological criteria used to evaluate real counseling sessions, ensuring alignment with expert evaluations. Experimental results demonstrate that Camel, a model trained with Cactus, outperforms other models in counseling skills, highlighting its effectiveness and potential as a counseling agent. We make our data, model, and code publicly available.

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.

Conversational agents are increasingly used to address emotional needs on top of information needs. One use case of increasing interest are counselling-style mental health and behaviour change interventions, with large language model (LLM)-based approaches becoming more popular. Research in this context so far has been largely system-focused, foregoing the aspect of user behaviour and the impact this can have on LLM-generated texts. To address this issue, we share a dataset containing text-based user interactions related to behaviour change with two GPT-4-based conversational agents collected in a preregistered user study. This dataset includes conversation data, user language analysis, perception measures, and user feedback for LLM-generated turns, and can offer valuable insights to inform the design of such systems based on real interactions.

In mental health counseling, a variety of earlier studies have focused on dialogue modeling. However, most of these studies give limited to no emphasis on the quality of interaction between a patient and a therapist. The therapeutic bond between a patient and a therapist directly correlates with effective mental health counseling. It involves developing the patient's trust on the therapist over the course of counseling. To assess the therapeutic bond in counseling, we introduce trust as a therapist-assistive metric. Our definition of trust involves patients' willingness and openness to express themselves and, consequently, receive better care. We conceptualize it as a dynamic trajectory observable through textual interactions during the counseling. To facilitate trust modeling, we present MENTAL-TRUST, a novel counseling dataset comprising manual annotation of 212 counseling sessions with first-of-its-kind seven expert-verified ordinal trust levels. We project our problem statement as an ordinal classification task for trust quantification and propose a new benchmark, TrustBench, comprising a suite of classical and state-of-the-art language models on MENTAL-TRUST. We evaluate the performance across a suite of metrics and lay out an exhaustive set of findings. Our study aims to unfold how trust evolves in therapeutic interactions.

Large language models (LLMs) have been widely applied in various fields due to their excellent capability for memorizing knowledge and chain of thought (CoT). When these language models are applied in the field of psychological counseling, they often rush to provide universal advice. However, when users seek psychological support, they need to gain empathy, trust, understanding and comfort, rather than just reasonable advice. To this end, we constructed a multi-turn empathetic conversation dataset of more than 2 million samples, in which the input is the multi-turn conversation context, and the target is empathetic responses that cover expressions such as questioning, comfort, recognition, listening, trust, emotional support, etc. Experiments have shown that the empathy ability of LLMs can be significantly enhanced when finetuning by using multi-turn dialogue history and responses that are closer to the expression of a psychological consultant.

As mental health issues globally escalate, there is a tremendous need for advanced digital support systems. We introduce MentalAgora, a novel framework employing large language models enhanced by interaction between multiple agents for tailored mental health support. This framework operates through three stages: strategic debating, tailored counselor creation, and response generation, enabling the dynamic customization of responses based on individual user preferences and therapeutic needs. We conduct experiments utilizing a high-quality evaluation dataset TherapyTalk crafted with mental health professionals, shwoing that MentalAgora generates expert-aligned and user preference-enhanced responses. Our evaluations, including experiments and user studies, demonstrate that MentalAgora aligns with professional standards and effectively meets user preferences, setting a new benchmark for digital mental health interventions.

Demand for mental health support through AI chatbots is surging, though current systems present several limitations, like sycophancy or overvalidation, and reinforcement of maladaptive beliefs. A core obstacle to the creation of better systems is the scarcity of benchmarks that capture the complexity of real therapeutic interactions. Most existing benchmarks either only test clinical knowledge through multiple-choice questions or assess single responses in isolation. To bridge this gap, we present MindEval, a framework designed in collaboration with Ph.D-level Licensed Clinical Psychologists for automatically evaluating language models in realistic, multi-turn mental health therapy conversations. Through patient simulation and automatic evaluation with LLMs, our framework balances resistance to gaming with reproducibility via its fully automated, model-agnostic design. We begin by quantitatively validating the realism of our simulated patients against human-generated text and by demonstrating strong correlations between automatic and human expert judgments. Then, we evaluate 12 state-of-the-art LLMs and show that all models struggle, scoring below 4 out of 6, on average, with particular weaknesses in problematic AI-specific patterns of communication. Notably, reasoning capabilities and model scale do not guarantee better performance, and systems deteriorate with longer interactions or when supporting patients with severe symptoms. We release all code, prompts, and human evaluation data.

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.

Cognitive Restructuring (CR) is a psychotherapeutic process aimed at identifying and restructuring an individual's negative thoughts, arising from mental health challenges, into more helpful and positive ones via multi-turn dialogues. Clinician shortage and stigma urge the development of human-LLM interactive psychotherapy for CR. Yet, existing efforts implement CR via simple text rewriting, fixed-pattern dialogues, or a one-shot CR workflow, failing to align with the psychotherapeutic process for effective CR. To address this gap, we propose CRDial, a novel framework for CR, which creates multi-turn dialogues with specifically designed identification and restructuring stages of negative thoughts, integrates sentence-level supportive conversation strategies, and adopts a multi-channel loop mechanism to enable iterative CR. With CRDial, we distill Crisp, a large-scale and high-quality bilingual dialogue dataset, from LLM. We then train Crispers, Crisp-based conversational LLMs for CR, at 7B and 14B scales. Extensive human studies show the superiority of Crispers in pointwise, pairwise, and intervention evaluations.

Current mental-health conversational systems are usually based on fixed, generic dialogue patterns. This paper proposes an adaptive framework based on large language models that aims to personalize therapeutic interaction according to a user's psychological state, quantified with the Acceptance of Illness Scale (AIS). The framework defines three specialized agents, L, M, and H, each linked to a different level of illness acceptance, and adjusts conversational behavior over time using continuous feedback signals. The AIS-stratified architecture is treated as a diegetic prototype placed in a plausible near-future setting and examined through the method of design fiction. By embedding the architecture in narrative scenarios, the study explores how such agents might influence access to care and therapeutic relationship. The goal is to show how clinically informed personalization, technical feasibility, and speculative scenario analysis can together inform the responsible design of LLM-based companions for mental-health support.

Recent advances in psychotherapy have focused on treatment personalization, such as by selecting treatment modules based on personalized networks. However, estimating personalized networks typically requires intensive longitudinal data, which is not always feasible. A solution to facilitate scalability of network-driven treatment personalization is leveraging LLMs. In this study, we present an end-to-end pipeline for automatically generating client networks from 77 therapy transcripts to support case conceptualization and treatment planning. We annotated 3364 psychological processes and their corresponding dimensions in therapy transcripts. Using these data, we applied in-context learning to jointly identify psychological processes and their dimensions. The method achieved high performance even with a few training examples. To organize the processes into networks, we introduced a two-step method that grouped them into clinically meaningful clusters. We then generated explanation-augmented relationships between clusters. Experts found that networks produced by our multi-step approach outperformed those built with direct prompting for clinical utility and interpretability, with up to 90% preferring our approach. In addition, the networks were rated favorably by experts, with scores for clinical relevance, novelty, and usefulness ranging from 72-75%. Our findings provide a proof of concept for using LLMs to create clinically relevant networks from therapy transcripts. Advantages of our approach include bottom-up case conceptualization from client utterances in therapy sessions and identification of latent themes. Networks generated from our pipeline may be used in clinical settings and supervision and training. Future research should examine whether these networks improve treatment outcomes relative to other methods of treatment personalization, including statistically estimated networks.

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.

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.

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.

This paper presents ChatCounselor, a large language model (LLM) solution designed to provide mental health support. Unlike generic chatbots, ChatCounselor is distinguished by its foundation in real conversations between consulting clients and professional psychologists, enabling it to possess specialized knowledge and counseling skills in the field of psychology. The training dataset, Psych8k, was constructed from 260 in-depth interviews, each spanning an hour. To assess the quality of counseling responses, the counseling Bench was devised. Leveraging GPT-4 and meticulously crafted prompts based on seven metrics of psychological counseling assessment, the model underwent evaluation using a set of real-world counseling questions. Impressively, ChatCounselor surpasses existing open-source models in the counseling Bench and approaches the performance level of ChatGPT, showcasing the remarkable enhancement in model capability attained through high-quality domain-specific data.

Due to the lack of human resources for mental health support, there is an increasing demand for employing conversational agents for support. Recent work has demonstrated the effectiveness of dialogue models in providing emotional support. As previous studies have demonstrated that seekers' persona is an important factor for effective support, we investigate whether there are benefits to modeling such information in dialogue models for support. In this paper, our empirical analysis verifies that persona has an important impact on emotional support. Therefore, we propose a framework for dynamically inferring and modeling seekers' persona. We first train a model for inferring the seeker's persona from the conversation history. Accordingly, we propose PAL, a model that leverages persona information and, in conjunction with our strategy-based controllable generation method, provides personalized emotional support. Automatic and manual evaluations demonstrate that PAL achieves state-of-the-art results, outperforming the baselines on the studied benchmark. Our code and data are publicly available at https://github.com/chengjl19/PAL.

Limited access to mental healthcare, extended wait times, and increasing capabilities of Large Language Models (LLMs) has led individuals to turn to LLMs for fulfilling their mental health needs. However, examining the multi-turn mental health conversation capabilities of LLMs remains under-explored. Existing evaluation frameworks typically focus on diagnostic accuracy and win-rates and often overlook alignment with patient-specific goals, values, and personalities required for meaningful conversations. To address this, we introduce MedAgent, a novel framework for synthetically generating realistic, multi-turn mental health sensemaking conversations and use it to create the Mental Health Sensemaking Dialogue (MHSD) dataset, comprising over 2,200 patient-LLM conversations. Additionally, we present MultiSenseEval, a holistic framework to evaluate the multi-turn conversation abilities of LLMs in healthcare settings using human-centric criteria. Our findings reveal that frontier reasoning models yield below-par performance for patient-centric communication and struggle at advanced diagnostic capabilities with average score of 31%. Additionally, we observed variation in model performance based on patient's persona and performance drop with increasing turns in the conversation. Our work provides a comprehensive synthetic data generation framework, a dataset and evaluation framework for assessing LLMs in multi-turn mental health conversations.

Emotional support dialogue systems aim to reduce help-seekers' distress and help them overcome challenges. While human valuesx2013core beliefs that shape an individual's prioritiesx2013are increasingly emphasized in contemporary psychological therapy for their role in fostering internal transformation and long-term emotional well-being, their integration into emotional support systems remains underexplored. To bridge this gap, we present a value-driven method for training emotional support dialogue systems designed to reinforce positive values in seekers. Notably, our model identifies which values to reinforce at each turn and how to do so, by leveraging online support conversations from Reddit. We evaluate the method across support skills, seekers' emotional intensity, and value reinforcement. Our method consistently outperforms various baselines, effectively exploring and eliciting values from seekers. Additionally, leveraging crowd knowledge from Reddit significantly enhances its effectiveness. Therapists highlighted its ability to validate seekers' challenges and emphasize positive aspects of their situationsx2013both crucial elements of value reinforcement. Our work, being the first to integrate value reinforcement into emotional support systems, demonstrates its promise and establishes a foundation for future research.

The recent advancements in artificial intelligence highlight the potential of language models in psychological health support. While models trained on data from mental health service platform have achieved preliminary success, challenges persist in areas such as data scarcity, quality, and ensuring a solid foundation in psychological techniques. To address these challenges, this study introduces a novel approach to enhance the precision and efficacy of psychological support through large language models. Specifically, we design a specific prompt derived from principles of Cognitive Behavioral Therapy (CBT) and have generated the CBT QA dataset, specifically for Chinese psychological health Q&A based on CBT structured intervention strategies. Unlike previous methods, our dataset emphasizes professional and structured response. Utilizing this dataset, we fine-tuned the large language model, giving birth to CBT-LLM, the large-scale language model specifically designed for Cognitive Behavioral Therapy techniques. Empirical evaluations demonstrate that CBT-LLM excels in generating structured, professional, and highly relevant responses in psychological health support tasks, showcasing its practicality and quality. The model is available on Hugging Face: https://huggingface.co/Hongbin37/CBT-LLM.

Generating psychological counseling responses with language models relies heavily on high-quality datasets. Crowdsourced data collection methods require strict worker training, and data from real-world counseling environments may raise privacy and ethical concerns. While recent studies have explored using large language models (LLMs) to augment psychological counseling dialogue datasets, the resulting data often suffers from limited diversity and authenticity. To address these limitations, this study adopts a role-playing approach where trained counselors simulate counselor-client interactions, ensuring high-quality dialogues while mitigating privacy risks. Using this method, we construct KokoroChat, a Japanese psychological counseling dialogue dataset comprising 6,589 long-form dialogues, each accompanied by comprehensive client feedback. Experimental results demonstrate that fine-tuning open-source LLMs with KokoroChat improves both the quality of generated counseling responses and the automatic evaluation of counseling dialogues. The KokoroChat dataset is available at https://github.com/UEC-InabaLab/KokoroChat.

Student mental health is a sensitive issue that necessitates special attention. A primary concern is the student-to-counselor ratio, which surpasses the recommended standard of 250:1 in most universities. This imbalance results in extended waiting periods for in-person consultations, which cause suboptimal treatment. Significant efforts have been directed toward developing mental health dialogue systems utilizing the existing open-source mental health-related datasets. However, currently available datasets either discuss general topics or various strategies that may not be viable for direct application due to numerous ethical constraints inherent in this research domain. To address this issue, this paper introduces a specialized mental health dataset that emphasizes the active listening strategy employed in conversation for counseling, also named as ConvCounsel. This dataset comprises both speech and text data, which can facilitate the development of a reliable pipeline for mental health dialogue systems. To demonstrate the utility of the proposed dataset, this paper also presents the NYCUKA, a spoken mental health dialogue system that is designed by using the ConvCounsel dataset. The results show the merit of using this dataset.

The recent surge of versatile large language models (LLMs) largely depends on aligning increasingly capable foundation models with human intentions by preference learning, enhancing LLMs with excellent applicability and effectiveness in a wide range of contexts. Despite the numerous related studies conducted, a perspective on how human preferences are introduced into LLMs remains limited, which may prevent a deeper comprehension of the relationships between human preferences and LLMs as well as the realization of their limitations. In this survey, we review the progress in exploring human preference learning for LLMs from a preference-centered perspective, covering the sources and formats of preference feedback, the modeling and usage of preference signals, as well as the evaluation of the aligned LLMs. We first categorize the human feedback according to data sources and formats. We then summarize techniques for human preferences modeling and compare the advantages and disadvantages of different schools of models. Moreover, we present various preference usage methods sorted by the objectives to utilize human preference signals. Finally, we summarize some prevailing approaches to evaluate LLMs in terms of alignment with human intentions and discuss our outlooks on the human intention alignment for LLMs.

The Mental Health Question Answer (MHQA) task requires the seeker and supporter to complete the support process in one-turn dialogue. Given the richness of help-seeker posts, supporters must thoroughly understand the content and provide logical, comprehensive, and well-structured responses. Previous works in MHQA mostly focus on single-agent approaches based on the cognitive element of Cognitive Behavioral Therapy (CBT), but they overlook the interactions among various CBT elements, such as emotion and cognition. This limitation hinders the models' ability to thoroughly understand the distress of help-seekers. To address this, we propose a framework named Multi-Agent Deductive Planning (MADP), which is based on the interactions between the various psychological elements of CBT. This method guides Large Language Models (LLMs) to achieve a deeper understanding of the seeker's context and provide more personalized assistance based on individual circumstances. Furthermore, we construct a new dataset based on the MADP framework and use it to fine-tune LLMs, resulting in a specialized model named MADP-LLM. We conduct extensive experiments, including comparisons with multiple LLMs, human evaluations, and automatic evaluations, to validate the effectiveness of the MADP framework and MADP-LLM.

In psychotherapy, therapeutic outcome assessment, or treatment outcome evaluation, is essential for enhancing mental health care by systematically evaluating therapeutic processes and outcomes. Existing large language model approaches often focus on therapist-centered, single-session evaluations, neglecting the client's subjective experience and longitudinal progress across multiple sessions. To address these limitations, we propose IPAEval, a client-Informed Psychological Assessment-based Evaluation framework that automates treatment outcome evaluations from the client's perspective using clinical interviews. IPAEval integrates cross-session client-contextual assessment and session-focused client-dynamics assessment to provide a comprehensive understanding of therapeutic progress. Experiments on our newly developed TheraPhase dataset demonstrate that IPAEval effectively tracks symptom severity and treatment outcomes over multiple sessions, outperforming previous single-session models and validating the benefits of items-aware reasoning mechanisms.

Large language models (LLMs) chatbots like ChatGPT are increasingly used for mental health support. They offer accessible, therapeutic support but also raise concerns about misinformation, over-reliance, and risks in high-stakes contexts of mental health. We crowdsource large-scale users' posts from six major social media platforms to examine how people discuss their interactions with LLM chatbots across different mental health conditions. Through an LLM-assisted pipeline grounded in Value-Sensitive Design (VSD), we mapped the relationships across user-reported sentiments, mental health conditions, perspectives, and values. Our results reveal that the use of LLM chatbots is condition-specific. Users with neurodivergent conditions (e.g., ADHD, ASD) report strong positive sentiments and instrumental or appraisal support, whereas higher-risk disorders (e.g., schizophrenia, bipolar disorder) show more negative sentiments. We further uncover how user perspectives co-occur with underlying values, such as identity, autonomy, and privacy. Finally, we discuss shifting from "one-size-fits-all" chatbot design toward condition-specific, value-sensitive LLM design.

The professionalism of a human doctor in outpatient service depends on two core abilities: the ability to make accurate medical decisions and the medical consultation skill to conduct strategic, empathetic patient inquiry. Existing Large Language Models (LLMs) have achieved remarkable accuracy on medical decision-making benchmarks. However, they often lack the ability to conduct the strategic and empathetic consultation, which is essential for real-world clinical scenarios. To address this gap, we propose Doctor-R1, an AI doctor agent trained to master both of the capabilities by ask high-yield questions and conduct strategic multi-turn inquiry to guide decision-making. Our framework introduces three key components: a multi-agent interactive environment, a two-tiered reward architecture that separately optimizes clinical decision-making and communicative inquiry skills, and an experience repository to ground policy learning in high-quality prior trajectories. We evaluate Doctor-R1 on OpenAI's HealthBench and MAQuE, assessed across multi-facet metrics, such as communication quality, user experience, and task accuracy. Remarkably, Doctor-R1 surpasses state-of-the-art open-source specialized LLMs by a substantial margin with higher parameter efficiency and outperforms powerful proprietary models. Furthermore, the human evaluations show a strong preference for Doctor-R1 to generate human-preferred clinical dialogue, demonstrating the effectiveness of the framework.

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.

Accurate assessment of personality traits is crucial for effective psycho-counseling, yet traditional methods like self-report questionnaires are time-consuming and biased. This study exams whether Large Language Models (LLMs) can predict the Big Five personality traits directly from counseling dialogues and introduces an innovative framework to perform the task. Our framework applies role-play and questionnaire-based prompting to condition LLMs on counseling sessions, simulating client responses to the Big Five Inventory. We evaluated our framework on 853 real-world counseling sessions, finding a significant correlation between LLM-predicted and actual Big Five traits, proving the validity of framework. Moreover, ablation studies highlight the importance of role-play simulations and task simplification via questionnaires in enhancing prediction accuracy. Meanwhile, our fine-tuned Llama3-8B model, utilizing Direct Preference Optimization with Supervised Fine-Tuning, achieves a 130.95\% improvement, surpassing the state-of-the-art Qwen1.5-110B by 36.94\% in personality prediction validity. In conclusion, LLMs can predict personality based on counseling dialogues. Our code and model are publicly available at https://github.com/kuri-leo/BigFive-LLM-Predictor, providing a valuable tool for future research in computational psychometrics.

Rising demand for mental health support has increased interest in using Large Language Models (LLMs) for counseling. However, adapting LLMs to this high-risk safety-critical domain is hindered by the scarcity of real-world counseling data due to privacy constraints. Synthetic datasets provide a promising alternative, but existing approaches often rely on unstructured or semi-structured text inputs and overlook structural dependencies between a client's cognitive, emotional, and behavioral states, often producing psychologically inconsistent interactions and reducing data realism and quality. We introduce Graph2Counsel, a framework for generating synthetic counseling sessions grounded in Client Psychological Graphs (CPGs) that encode relationships among clients' thoughts, emotions, and behaviors. Graph2Counsel employs a structured prompting pipeline guided by counselor strategies and CPG, and explores prompting strategies including CoT (Wei et al., 2022) and Multi-Agent Feedback (Li et al., 2025a). Graph2Counsel produces 760 sessions from 76 CPGs across diverse client profiles. In expert evaluation, our dataset outperforms prior datasets on specificity, counselor competence, authenticity, conversational flow, and safety, with substantial inter-annotator agreement (Krippendorff's α = 0.70). Fine-tuning an open-source model on this dataset improves performance on CounselingBench (Nguyen et al., 2025) and CounselBench (Li et al., 2025b), showing downstream utility. We also make our code and data public.

Simulating human clients in mental health counseling is crucial for training and evaluating counselors (both human or simulated) in a scalable manner. Nevertheless, past research on client simulation did not focus on complex conversation tasks such as mental health counseling. In these tasks, the challenge is to ensure that the client's actions (i.e., interactions with the counselor) are consistent with with its stipulated profiles and negative behavior settings. In this paper, we propose a novel framework that supports consistent client simulation for mental health counseling. Our framework tracks the mental state of a simulated client, controls its state transitions, and generates for each state behaviors consistent with the client's motivation, beliefs, preferred plan to change, and receptivity. By varying the client profile and receptivity, we demonstrate that consistent simulated clients for different counseling scenarios can be effectively created. Both our automatic and expert evaluations on the generated counseling sessions also show that our client simulation method achieves higher consistency than previous methods.

As mental health care systems worldwide struggle to meet demand, there is increasing focus on using language models to infer neuropsychiatric conditions or psychopathological traits from language production. Yet, so far, this research has only delivered solutions with limited clinical applicability, due to insufficient consideration of ethical questions crucial to ensuring the synergy between possible applications and model design. To accelerate progress towards clinically applicable models, our paper charts the ethical landscape of research on language-based inference of psychopathology and provides a practical tool for researchers to navigate it. We identify seven core ethical principles that should guide model development and deployment in this domain, translate them into ELLIPS, an ethical toolkit operationalizing these principles into questions that can guide researchers' choices with respect to data selection, architectures, evaluation, and model deployment, and provide a case study exemplifying its use. With this, we aim to facilitate the emergence of model technology with concrete potential for real-world applicability.

Language Models (LMs) are being proposed for mental health applications where the heightened risk of adverse outcomes means predictive performance may not be a sufficient litmus test of a model's utility in clinical practice. A model that can be trusted for practice should have a correspondence between explanation and clinical determination, yet no prior research has examined the attention fidelity of these models and their effect on ground truth explanations. We introduce an evaluation design that focuses on the robustness and explainability of LMs in identifying Wellness Dimensions (WDs). We focus on two existing mental health and well-being datasets: (a) Multi-label Classification-based MultiWD, and (b) WellXplain for evaluating attention mechanism veracity against expert-labeled explanations. The labels are based on Halbert Dunn's theory of wellness, which gives grounding to our evaluation. We reveal four surprising results about LMs/LLMs: (1) Despite their human-like capabilities, GPT-3.5/4 lag behind RoBERTa, and MedAlpaca, a fine-tuned LLM on WellXplain fails to deliver any remarkable improvements in performance or explanations. (2) Re-examining LMs' predictions based on a confidence-oriented loss function reveals a significant performance drop. (3) Across all LMs/LLMs, the alignment between attention and explanations remains low, with LLMs scoring a dismal 0.0. (4) Most mental health-specific LMs/LLMs overlook domain-specific knowledge and undervalue explanations, causing these discrepancies. This study highlights the need for further research into their consistency and explanations in mental health and well-being.

In the field of psychology, traditional assessment methods, such as standardized scales, are frequently critiqued for their static nature, lack of personalization, and reduced participant engagement, while comprehensive counseling evaluations are often inaccessible. The complexity of quantifying psychological traits further limits these methods. Despite advances with large language models (LLMs), many still depend on single-round Question-and-Answer interactions. To bridge this gap, we introduce PsyDI, a personalized and progressively in-depth chatbot designed for psychological measurements, exemplified by its application in the Myers-Briggs Type Indicator (MBTI) framework. PsyDI leverages user-related multi-modal information and engages in customized, multi-turn interactions to provide personalized, easily accessible measurements, while ensuring precise MBTI type determination. To address the challenge of unquantifiable psychological traits, we introduce a novel training paradigm that involves learning the ranking of proxy variables associated with these traits, culminating in a robust score model for MBTI measurements. The score model enables PsyDI to conduct comprehensive and precise measurements through multi-turn interactions within a unified estimation context. Through various experiments, we validate the efficacy of both the score model and the PsyDI pipeline, demonstrating its potential to serve as a general framework for psychological measurements. Furthermore, the online deployment of PsyDI has garnered substantial user engagement, with over 3,000 visits, resulting in the collection of numerous multi-turn dialogues annotated with MBTI types, which facilitates further research.

In natural human-to-human conversations, participants often receive feedback signals from one another based on their follow-up reactions. These reactions can include verbal responses, facial expressions, changes in emotional state, and other non-verbal cues. Similarly, in human-machine interactions, the machine can leverage the user's follow-up utterances as feedback signals to assess whether it has appropriately addressed the user's request. Therefore, we propose using the likelihood of follow-up utterances as rewards to differentiate preferred responses from less favored ones, without relying on human or commercial LLM-based preference annotations. Our proposed reward mechanism, ``Follow-up Likelihood as Reward" (FLR), matches the performance of strong reward models trained on large-scale human or GPT-4 annotated data on 8 pairwise-preference and 4 rating-based benchmarks. Building upon the FLR mechanism, we propose to automatically mine preference data from the online generations of a base policy model. The preference data are subsequently used to boost the helpfulness of the base model through direct alignment from preference (DAP) methods, such as direct preference optimization (DPO). Lastly, we demonstrate that fine-tuning the language model that provides follow-up likelihood with natural language feedback significantly enhances FLR's performance on reward modeling benchmarks and effectiveness in aligning the base policy model's helpfulness.

As language models (LMs) become more capable, it is increasingly important to align them with human preferences. However, the dominant paradigm for training Preference Models (PMs) for that purpose suffers from fundamental limitations, such as lack of transparency and scalability, along with susceptibility to overfitting the preference dataset. We propose Compositional Preference Models (CPMs), a novel PM framework that decomposes one global preference assessment into several interpretable features, obtains scalar scores for these features from a prompted LM, and aggregates these scores using a logistic regression classifier. Through these simple steps, CPMs allow to control which properties of the preference data are used to train the preference model and to build it based on features that are believed to underlie the human preference judgment. Our experiments show that CPMs not only improve generalization and are more robust to overoptimization than standard PMs, but also that best-of-n samples obtained using CPMs tend to be preferred over samples obtained using conventional PMs. Overall, our approach demonstrates the benefits of endowing PMs with priors about which features determine human preferences while relying on LM capabilities to extract those features in a scalable and robust way.

Large Language Models (LLMs) in mental healthcare risk propagating biases that reinforce stigma and harm marginalized groups. While previous research identified concerning trends, systematic methods for detecting intersectional biases remain limited. This work introduces a multi-hop question answering (MHQA) framework to explore LLM response biases in mental health discourse. We analyze content from the Interpretable Mental Health Instruction (IMHI) dataset across symptom presentation, coping mechanisms, and treatment approaches. Using systematic tagging across age, race, gender, and socioeconomic status, we investigate bias patterns at demographic intersections. We evaluate four LLMs: Claude 3.5 Sonnet, Jamba 1.6, Gemma 3, and Llama 4, revealing systematic disparities across sentiment, demographics, and mental health conditions. Our MHQA approach demonstrates superior detection compared to conventional methods, identifying amplification points where biases magnify through sequential reasoning. We implement two debiasing techniques: Roleplay Simulation and Explicit Bias Reduction, achieving 66-94% bias reductions through few-shot prompting with BBQ dataset examples. These findings highlight critical areas where LLMs reproduce mental healthcare biases, providing actionable insights for equitable AI development.

Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.

Evaluating Large Language Models (LLMs) for mental health support is challenging due to the emotionally and cognitively complex nature of therapeutic dialogue. Existing benchmarks are limited in scale, reliability, often relying on synthetic or social media data, and lack frameworks to assess when automated judges can be trusted. To address the need for large-scale dialogue datasets and judge reliability assessment, we introduce two benchmarks that provide a framework for generation and evaluation. MentalBench-100k consolidates 10,000 one-turn conversations from three real scenarios datasets, each paired with nine LLM-generated responses, yielding 100,000 response pairs. MentalAlign-70k}reframes evaluation by comparing four high-performing LLM judges with human experts across 70,000 ratings on seven attributes, grouped into Cognitive Support Score (CSS) and Affective Resonance Score (ARS). We then employ the Affective Cognitive Agreement Framework, a statistical methodology using intraclass correlation coefficients (ICC) with confidence intervals to quantify agreement, consistency, and bias between LLM judges and human experts. Our analysis reveals systematic inflation by LLM judges, strong reliability for cognitive attributes such as guidance and informativeness, reduced precision for empathy, and some unreliability in safety and relevance. Our contributions establish new methodological and empirical foundations for reliable, large-scale evaluation of LLMs in mental health. We release the benchmarks and codes at: https://github.com/abeerbadawi/MentalBench/

Large language models (LLMs) can be said to have preferences: they reliably pick certain tasks and outputs over others, and preferences shaped by post-training and system prompts appear to shape much of their behaviour. But models can also adopt different personas which have radically different preferences. How is this implemented internally? Does each persona run on its own preference machinery, or is something shared underneath? We train linear probes on residual-stream activations of Gemma-3-27B and Qwen-3.5-122B to predict revealed pairwise task choices, and identify a genuine preference vector: it tracks the model's preferences as they shift across a range of prompts and situations, and on Gemma-3-27B steering along it causally controls pairwise choice. This preference representation is largely shared across personas: a probe trained on the helpful assistant predicts and steers the choices of qualitatively different personas, including an evil persona whose preferences anti-correlate with those of the Assistant.

Learning from preference feedback has emerged as an essential step for improving the generation quality and performance of modern language models (LMs). Despite its widespread use, the way preference-based learning is applied varies wildly, with differing data, learning algorithms, and evaluations used, making disentangling the impact of each aspect difficult. In this work, we identify four core aspects of preference-based learning: preference data, learning algorithm, reward model, and policy training prompts, systematically investigate the impact of these components on downstream model performance, and suggest a recipe for strong learning for preference feedback. Our findings indicate that all aspects are important for performance, with better preference data leading to the largest improvements, followed by the choice of learning algorithm, the use of improved reward models, and finally the use of additional unlabeled prompts for policy training. Notably, PPO outperforms DPO by up to 2.5% in math and 1.2% in general domains. High-quality preference data leads to improvements of up to 8% in instruction following and truthfulness. Despite significant gains of up to 5% in mathematical evaluation when scaling up reward models, we surprisingly observe marginal improvements in other categories. We publicly release the code used for training (https://github.com/hamishivi/EasyLM) and evaluating (https://github.com/allenai/open-instruct) our models, along with the models and datasets themselves (https://huggingface.co/collections/allenai/tulu-v25-suite-66676520fd578080e126f618).

As large language models (LLMs) enter the mainstream, aligning them to foster constructive dialogue rather than exacerbate societal divisions is critical. Using an individualized and multicultural alignment dataset of over 7,500 conversations of individuals from 74 countries engaging with 21 LLMs, we examined how linguistic attributes linked to constructive interactions are reflected in human preference data used for training AI. We found that users consistently preferred well-reasoned and nuanced responses while rejecting those high in personal storytelling. However, users who believed that AI should reflect their values tended to place less preference on reasoning in LLM responses and more on curiosity. Encouragingly, we observed that users could set the tone for how constructive their conversation would be, as LLMs mirrored linguistic attributes, including toxicity, in user queries.

As a relative quality comparison of model responses, human and Large Language Model (LLM) preferences serve as common alignment goals in model fine-tuning and criteria in evaluation. Yet, these preferences merely reflect broad tendencies, resulting in less explainable and controllable models with potential safety risks. In this work, we dissect the preferences of human and 32 different LLMs to understand their quantitative composition, using annotations from real-world user-model conversations for a fine-grained, scenario-wise analysis. We find that humans are less sensitive to errors, favor responses that support their stances, and show clear dislike when models admit their limits. On the contrary, advanced LLMs like GPT-4-Turbo emphasize correctness, clarity, and harmlessness more. Additionally, LLMs of similar sizes tend to exhibit similar preferences, regardless of their training methods, and fine-tuning for alignment does not significantly alter the preferences of pretrained-only LLMs. Finally, we show that preference-based evaluation can be intentionally manipulated. In both training-free and training-based settings, aligning a model with the preferences of judges boosts scores, while injecting the least preferred properties lowers them. This results in notable score shifts: up to 0.59 on MT-Bench (1-10 scale) and 31.94 on AlpacaEval 2.0 (0-100 scale), highlighting the significant impact of this strategic adaptation. Interactive Demo: https://huggingface.co/spaces/GAIR/Preference-Dissection-Visualization Dataset: https://huggingface.co/datasets/GAIR/preference-dissection Code: https://github.com/GAIR-NLP/Preference-Dissection

This paper presents OnCoCo 1.0, a new public dataset for fine-grained message classification in online counseling. It is based on a new, integrative system of categories, designed to improve the automated analysis of psychosocial online counseling conversations. Existing category systems, predominantly based on Motivational Interviewing (MI), are limited by their narrow focus and dependence on datasets derived mainly from face-to-face counseling. This limits the detailed examination of textual counseling conversations. In response, we developed a comprehensive new coding scheme that differentiates between 38 types of counselor and 28 types of client utterances, and created a labeled dataset consisting of about 2.800 messages from counseling conversations. We fine-tuned several models on our dataset to demonstrate its applicability. The data and models are publicly available to researchers and practitioners. Thus, our work contributes a new type of fine-grained conversational resource to the language resources community, extending existing datasets for social and mental-health dialogue analysis.

Aligning the behaviors of Multimodal Large Language Models (MLLMs) with human preferences is crucial for developing robust and trustworthy AI systems. While recent attempts have employed human experts or powerful auxiliary AI systems to provide more accurate preference feedback, such as determining the preferable responses from MLLMs or directly rewriting hallucination-free responses, extensive resource overhead compromise the scalability of the feedback collection. In this work, we introduce Topic-level Preference Overwriting (TPO), a self-correctional approach that guide the model itself to mitigate its own hallucination at the topic level. Through a deconfounded strategy that replaces each topic within the response with the best or worst alternatives generated by the model itself, TPO creates more contrasting pairwise preference feedback, enhancing the feedback quality without human or proprietary model intervention. Notably, the experimental results demonstrate proposed TPO achieves state-of-the-art performance in trustworthiness, significantly reducing the object hallucinations by 92% and overall hallucinations by 38%. Code, model and data will be released.

Aligning the output of Large Language Models (LLMs) with human preferences (e.g., by means of reinforcement learning with human feedback, or RLHF) is essential for ensuring their effectiveness in real-world scenarios. Despite significant advancements in LLM alignment techniques, the impact of different type of preference data on model performance has yet to be systematically explored. In this study, we investigate the scalability, data efficiency, and effectiveness of Direct Preference Optimization (DPO) in fine-tuning pre-trained LLMs, aiming to reduce their dependency on extensive amounts of preference data, which is expensive to collect. We (1) systematically compare the performance of models fine-tuned with varying percentages of a combined preference judgement dataset to define the improvement curve of DPO and assess its effectiveness in data-constrained environments; and (2) provide insights for the development of an optimal approach for selective preference data usage. Our study reveals that increasing the amount of data used for training generally enhances and stabilizes model performance. Moreover, the use of a combination of diverse datasets significantly improves model effectiveness. Furthermore, when models are trained separately using different types of prompts, models trained with conversational prompts outperformed those trained with question answering prompts.

The growing emotional stress in modern society has increased the demand for Emotional Support Conversations (ESC). While Large Language Models (LLMs) show promise for ESC, they face two key challenges: (1) low strategy selection accuracy, and (2) preference bias, limiting their adaptability to emotional needs of users. Existing supervised fine-tuning (SFT) struggles to address these issues, as it rigidly trains models on single gold-standard responses without modeling nuanced strategy trade-offs. To overcome these limitations, we propose Chain-of-Strategy Optimization (CSO), a novel approach that optimizes strategy selection preferences at each dialogue turn. We first leverage Monte Carlo Tree Search to construct ESC-Pro, a high-quality preference dataset with turn-level strategy-response pairs. Training on ESC-Pro with CSO improves both strategy accuracy and bias mitigation, enabling LLMs to generate more empathetic and contextually appropriate responses. Experiments on LLaMA-3.1-8B, Gemma-2-9B, and Qwen2.5-7B demonstrate that CSO outperforms standard SFT, highlighting the efficacy of fine-grained, turn-level preference modeling in ESC.

Recent researches of large language models(LLM), which is pre-trained on massive general-purpose corpora, have achieved breakthroughs in responding human queries. However, these methods face challenges including limited data insufficiency to support extensive pre-training and can not align responses with users' instructions. To address these issues, we introduce a medical instruction dataset, CMedINS, containing six medical instructions derived from actual medical tasks, which effectively fine-tunes LLM in conjunction with other data. Subsequently, We launch our medical model, IIMedGPT, employing an efficient preference alignment method, Direct preference Optimization(DPO). The results show that our final model outperforms existing medical models in medical dialogue.Datsets, Code and model checkpoints will be released upon acceptance.

We present HamRaz, a culturally adapted Persian-language dataset for AI-assisted mental health support, grounded in Person-Centered Therapy (PCT). To reflect real-world therapeutic challenges, we combine script-based dialogue with adaptive large language models (LLM) role-playing, capturing the ambiguity and emotional nuance of Persian-speaking clients. We introduce HamRazEval, a dual-framework for assessing conversational and therapeutic quality using General Metrics and specialized psychological relationship measures. Human evaluations show HamRaz outperforms existing baselines in empathy, coherence, and realism. This resource contributes to the Digital Humanities by bridging language, culture, and mental health in underrepresented communities.

Given the broad capabilities of large language models, it should be possible to work towards a general-purpose, text-based assistant that is aligned with human values, meaning that it is helpful, honest, and harmless. As an initial foray in this direction we study simple baseline techniques and evaluations, such as prompting. We find that the benefits from modest interventions increase with model size, generalize to a variety of alignment evaluations, and do not compromise the performance of large models. Next we investigate scaling trends for several training objectives relevant to alignment, comparing imitation learning, binary discrimination, and ranked preference modeling. We find that ranked preference modeling performs much better than imitation learning, and often scales more favorably with model size. In contrast, binary discrimination typically performs and scales very similarly to imitation learning. Finally we study a `preference model pre-training' stage of training, with the goal of improving sample efficiency when finetuning on human preferences.

Current large language model (LLM) development treats task-solving and preference alignment as separate challenges, optimizing first for objective correctness, then for alignment to aggregated human preferences. This paradigm fails in human-facing applications where solving a problem correctly is insufficient if the response mismatches the user's needs. This challenge intensifies in just-in-time scenarios where no prior user interaction history exists due to cold-start conditions or privacy constraints. LLMs need to identify what they don't know about user preferences, strategically elicit preference values through questioning, then adapt their reasoning processes and responses accordingly -- a complicated chain of cognitive processes which we term personalized reasoning. We introduce PREFDISCO, an evaluation methodology that transforms static benchmarks into interactive personalization tasks using psychologically-grounded personas with sparse preferences. Our framework creates scenarios where identical questions require different reasoning chains depending on user context, as optimal explanation approaches vary by individual expertise and preferences while maintaining factual accuracy. Evaluation of 21 frontier models across 10 tasks reveals 29.0% of naive personalization attempts produce worse preference alignment than generic responses, yet generic responses also fail to serve individual user needs effectively. These findings suggest personalized reasoning requires dedicated development rather than emerging naturally. PREFDISCO establishes personalized reasoning as a measurable research frontier and reveals fundamental limitations in current LLMs' interactive capabilities, providing a foundation for developing systems that can adapt to individual users in education, healthcare, and technical domains where personalization is critical.

The advancement of AI systems for mental health support is hindered by limited access to therapeutic conversation data, particularly for trauma treatment. We present Thousand Voices of Trauma, a synthetic benchmark dataset of 3,000 therapy conversations based on Prolonged Exposure therapy protocols for Post-traumatic Stress Disorder (PTSD). The dataset comprises 500 unique cases, each explored through six conversational perspectives that mirror the progression of therapy from initial anxiety to peak distress to emotional processing. We incorporated diverse demographic profiles (ages 18-80, M=49.3, 49.4% male, 44.4% female, 6.2% non-binary), 20 trauma types, and 10 trauma-related behaviors using deterministic and probabilistic generation methods. Analysis reveals realistic distributions of trauma types (witnessing violence 10.6%, bullying 10.2%) and symptoms (nightmares 23.4%, substance abuse 20.8%). Clinical experts validated the dataset's therapeutic fidelity, highlighting its emotional depth while suggesting refinements for greater authenticity. We also developed an emotional trajectory benchmark with standardized metrics for evaluating model responses. This privacy-preserving dataset addresses critical gaps in trauma-focused mental health data, offering a valuable resource for advancing both patient-facing applications and clinician training tools.

Recent progress on large language models (LLMs) has enabled dialogue agents to generate highly naturalistic and plausible text. However, current LLM language generation focuses on responding accurately to questions and requests with a single effective response. In reality, many real dialogues are interactive, meaning an agent's utterances will influence their conversational partner, elicit information, or change their opinion. Accounting for how an agent can effectively steer a conversation is a crucial ability in many dialogue tasks, from healthcare to preference elicitation. Existing methods for fine-tuning dialogue agents to accomplish such tasks would rely on curating some amount of expert data. However, doing so often requires understanding the underlying cognitive processes of the conversational partner, which is a skill neither humans nor LLMs trained on human data can reliably do. Our key insight is that while LLMs may not be adept at identifying effective strategies for steering conversations a priori, or in the middle of an ongoing conversation, they can do so post-hoc, or in hindsight, after seeing how their conversational partner responds. We use this fact to rewrite and augment existing suboptimal data, and train via offline reinforcement learning (RL) an agent that outperforms both prompting and learning from unaltered human demonstrations. We apply our approach to two domains that require understanding human mental state, intelligent interaction, and persuasion: mental health support, and soliciting charitable donations. Our results in a user study with real humans show that our approach greatly outperforms existing state-of-the-art dialogue agents.

In day-to-day communication, people often approximate the truth - for example, rounding the time or omitting details - in order to be maximally helpful to the listener. How do large language models (LLMs) handle such nuanced trade-offs? To address this question, we use psychological models and experiments designed to characterize human behavior to analyze LLMs. We test a range of LLMs and explore how optimization for human preferences or inference-time reasoning affects these trade-offs. We find that reinforcement learning from human feedback improves both honesty and helpfulness, while chain-of-thought prompting skews LLMs towards helpfulness over honesty. Finally, GPT-4 Turbo demonstrates human-like response patterns including sensitivity to the conversational framing and listener's decision context. Our findings reveal the conversational values internalized by LLMs and suggest that even these abstract values can, to a degree, be steered by zero-shot prompting.

User preferences are increasingly used to personalize Large Language Model (LLM) responses, yet how to reliably leverage preference signals for answer generation remains under-explored. In practice, preferences can be noisy, incomplete, or even misleading, which can degrade answer quality when applied naively. Motivated by the observation that stable personality traits shape everyday preferences, we study personality as a principled ''latent'' signal behind preference statements. Through extensive experiments, we find that conditioning on personality-aligned preferences substantially improves personalized question answering: selecting preferences consistent with a user's inferred personality increases answer-choice accuracy from 29.25% to 76%, compared to using randomly selected preferences. Based on these findings, we introduce PACIFIC (Preference Alignment Choices Inference for Five-factor Identity Characterization), a personality-labeled preference dataset containing 1200 preference statements spanning diverse domains (e.g., travel, movies, education), annotated with Big-Five (OCEAN) trait directions. Finally, we propose a framework that enables an LLM model to automatically retrieve personality-aligned preferences and incorporate them during answer generation.

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

Human-like personality traits have recently been discovered in large language models, raising the hypothesis that their (known and as yet undiscovered) biases conform with human latent psychological constructs. While large conversational models may be tricked into answering psychometric questionnaires, the latent psychological constructs of thousands of simpler transformers, trained for other tasks, cannot be assessed because appropriate psychometric methods are currently lacking. Here, we show how standard psychological questionnaires can be reformulated into natural language inference prompts, and we provide a code library to support the psychometric assessment of arbitrary models. We demonstrate, using a sample of 88 publicly available models, the existence of human-like mental health-related constructs (including anxiety, depression, and Sense of Coherence) which conform with standard theories in human psychology and show similar correlations and mitigation strategies. The ability to interpret and rectify the performance of language models by using psychological tools can boost the development of more explainable, controllable, and trustworthy models.

Existing preference optimization methods are mainly designed for directly learning from human feedback with the assumption that paired examples (preferred vs. dis-preferred) are available. In contrast, we propose a method that can leverage unpaired preferred or dis-preferred examples, and works even when only one type of feedback (positive or negative) is available. This flexibility allows us to apply it in scenarios with varying forms of feedback and models, including training generative language models based on human feedback as well as training policies for sequential decision-making problems, where learned (value) functions are available. Our approach builds upon the probabilistic framework introduced in (Dayan and Hinton, 1997), which proposes to use expectation-maximization (EM) to directly optimize the probability of preferred outcomes (as opposed to classic expected reward maximization). To obtain a practical algorithm, we identify and address a key limitation in current EM-based methods: when applied to preference optimization, they solely maximize the likelihood of preferred examples, while neglecting dis-preferred samples. We show how one can extend EM algorithms to explicitly incorporate dis-preferred outcomes, leading to a novel, theoretically grounded, preference optimization algorithm that offers an intuitive and versatile way to learn from both positive and negative feedback.

Empathetic response generation is a desirable aspect of conversational agents, crucial for facilitating engaging and emotionally intelligent multi-turn conversations between humans and machines. Leveraging large language models for this task has shown promising results, yet challenges persist in ensuring both the empathetic quality of the responses and retention of the generalization performance of the models. We propose a novel approach where we construct theory-driven preference datasets based on emotion grounding and use them to align LLMs with preference optimization algorithms to address these challenges. To evaluate empathetic response generation, we employ the EmpatheticDialogues dataset, assessing empathy with the diff-Epitome and BERTscore metrics and with multi-dimensional human evaluation. Additionally, we measure diversity and emotional valence using feature-based methods. We also evaluate the impact of training on the generalization performance using the MMLU benchmark and tasks from the Open LLM Leaderboard. The results show that LLMs can be aligned for empathetic response generation by preference optimization while retaining their general performance and that emotion grounding can guide preference dataset creation. We make all datasets, source code, and models publicly available. https://github.com/justtherightsize/empo

Preference modeling techniques, such as direct preference optimization (DPO), has shown effective in enhancing the generalization abilities of large language model (LLM). However, in tasks involving video instruction-following, providing informative feedback, especially for detecting hallucinations in generated responses, remains a significant challenge. Previous studies have explored using large large multimodal models (LMMs) as reward models to guide preference modeling, but their ability to accurately assess the factuality of generated responses compared to corresponding videos has not been conclusively established. This paper introduces a novel framework that utilizes detailed video captions as a proxy of video content, enabling language models to incorporate this information as supporting evidence for scoring video Question Answering (QA) predictions. Our approach demonstrates robust alignment with OpenAI GPT-4V model's reward mechanism, which directly takes video frames as input. Furthermore, we show that applying this tailored reward through DPO significantly improves the performance of video LMMs on video QA tasks.

Large Language Models (LLMs) are increasingly utilized for mental health support; however, current safety benchmarks often fail to detect the complex, longitudinal risks inherent in therapeutic dialogue. We introduce an evaluation framework that pairs AI psychotherapists with simulated patient agents equipped with dynamic cognitive-affective models and assesses therapy session simulations against a comprehensive quality of care and risk ontology. We apply this framework to a high-impact test case, Alcohol Use Disorder, evaluating six AI agents (including ChatGPT, Gemini, and Character.AI) against a clinically-validated cohort of 15 patient personas representing diverse clinical phenotypes. Our large-scale simulation (N=369 sessions) reveals critical safety gaps in the use of AI for mental health support. We identify specific iatrogenic risks, including the validation of patient delusions ("AI Psychosis") and failure to de-escalate suicide risk. Finally, we validate an interactive data visualization dashboard with diverse stakeholders, including AI engineers and red teamers, mental health professionals, and policy experts (N=9), demonstrating that this framework effectively enables stakeholders to audit the "black box" of AI psychotherapy. These findings underscore the critical safety risks of AI-provided mental health support and the necessity of simulation-based clinical red teaming before deployment.

Large language models (LLMs) have performed well in providing general and extensive health suggestions in single-turn conversations, exemplified by systems such as ChatGPT, ChatGLM, ChatDoctor, DoctorGLM, and etc. However, the limited information provided by users during single turn results in inadequate personalization and targeting of the generated suggestions, which requires users to independently select the useful part. It is mainly caused by the missing ability to engage in multi-turn questioning. In real-world medical consultations, doctors usually employ a series of iterative inquiries to comprehend the patient's condition thoroughly, enabling them to provide effective and personalized suggestions subsequently, which can be defined as chain of questioning (CoQ) for LLMs. To improve the CoQ of LLMs, we propose BianQue, a ChatGLM-based LLM finetuned with the self-constructed health conversation dataset BianQueCorpus that is consist of multiple turns of questioning and health suggestions polished by ChatGPT. Experimental results demonstrate that the proposed BianQue can simultaneously balance the capabilities of both questioning and health suggestions, which will help promote the research and application of LLMs in the field of proactive health.

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.

The rapid advancement of large language models (LLMs) has facilitated their transformation into conversational chatbots that can grasp contextual nuances and generate pertinent sentences, closely mirroring human values through advanced techniques such as instruction tuning and reinforcement learning from human feedback (RLHF). However, the computational efficiency required for LLMs, achieved through techniques like post-training quantization (PTQ), presents challenges such as token-flipping that can impair chatbot performance. In response, we propose a novel preference alignment approach, quantization-aware direct preference optimization (QDPO), that aligns quantized LLMs with their full-precision counterparts, improving conversational abilities. Evaluated on two instruction-tuned LLMs in various languages, QDPO demonstrated superior performance in improving conversational abilities compared to established PTQ and knowledge-distillation fine-tuning techniques, marking a significant step forward in the development of efficient and effective conversational LLMs.

While NLP research has made strides in conversational tasks, many approaches focus on single-turn responses with well-defined objectives or evaluation criteria. In contrast, coaching presents unique challenges with initially undefined goals that evolve through multi-turn interactions, subjective evaluation criteria, mixed-initiative dialogue. In this work, we describe and implement five multi-turn coaching agents that exhibit distinct conversational styles, and evaluate them through a user study, collecting first-person feedback on 155 conversations. We find that users highly value core functionality, and that stylistic components in absence of core components are viewed negatively. By comparing user feedback with third-person evaluations from health experts and an LM, we reveal significant misalignment across evaluation approaches. Our findings provide insights into design and evaluation of conversational coaching agents and contribute toward improving human-centered NLP applications.

Today, large language models are widely used as judges to evaluate responses from other language models. Hence, it is imperative to benchmark and improve these LLM-judges on real-world language model usage: a typical human-assistant conversation is lengthy, and shows significant diversity in topics, intents, and requirements across turns, e.g. social interactions, task requests, feedback. We present Amulet, a framework that leverages pertinent linguistic concepts of dialog-acts and maxims to improve the accuracy of LLM-judges on preference data with complex, multi-turn conversational context. Amulet presents valuable insights about (a) the communicative structures and intents present in the conversation (dialog acts), and (b) the satisfaction of conversational principles (maxims) by the preference responses, and uses them to make judgments. On four challenging datasets, Amulet shows that (a) humans frequently (60 to 70 percent of the time) change their intents from one turn of the conversation to the next, and (b) in 75 percent of instances, the preference responses can be differentiated via dialog acts and/or maxims, reiterating the latter's significance in judging such data. Amulet can be used either as a judge by applying the framework to a single LLM, or integrated into a jury with different LLM judges; our judges and juries show strong improvements on relevant baselines for all four datasets.

Realistic practice and tailored feedback are key processes for training peer counselors with clinical skills. However, existing mechanisms of providing feedback largely rely on human supervision. Peer counselors often lack mechanisms to receive detailed feedback from experienced mentors, making it difficult for them to support the large number of people with mental health issues who use peer counseling. Our work aims to leverage large language models to provide contextualized and multi-level feedback to empower peer counselors, especially novices, at scale. To achieve this, we co-design with a group of senior psychotherapy supervisors to develop a multi-level feedback taxonomy, and then construct a publicly available dataset with comprehensive feedback annotations of 400 emotional support conversations. We further design a self-improvement method on top of large language models to enhance the automatic generation of feedback. Via qualitative and quantitative evaluation with domain experts, we demonstrate that our method minimizes the risk of potentially harmful and low-quality feedback generation which is desirable in such high-stakes scenarios.

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.

A critical factor in the success of decision support systems is the accurate modeling of user preferences. Psychology research has demonstrated that users often develop their preferences during the elicitation process, highlighting the pivotal role of system-user interaction in developing personalized systems. This paper introduces a novel approach, combining Large Language Models (LLMs) with Constraint Programming to facilitate interactive decision support. We study this hybrid framework through the lens of meeting scheduling, a time-consuming daily activity faced by a multitude of information workers. We conduct three studies to evaluate the novel framework, including a diary study (n=64) to characterize contextual scheduling preferences, a quantitative evaluation of the system's performance, and a user study (n=10) with a prototype system. Our work highlights the potential for a hybrid LLM and optimization approach for iterative preference elicitation and design considerations for building systems that support human-system collaborative decision-making processes.

Methods for controlling large language models (LLMs), including local weight fine-tuning, LoRA-based adaptation, and activation-based interventions, are often studied in isolation, obscuring their connections and making comparison difficult. In this work, we present a unified view that frames these interventions as dynamic weight updates induced by a control signal, placing them within a single conceptual framework. Building on this view, we propose a unified preference-utility analysis that separates control effects into preference, defined as the tendency toward a target concept, and utility, defined as coherent and task-valid generation, and measures both on a shared log-odds scale using polarity-paired contrastive examples. Across methods, we observe a consistent trade-off between preference and utility: stronger control increases preference while predictably reducing utility. We further explain this behavior through an activation manifold perspective, in which control shifts representations along target-concept directions to enhance preference, while utility declines primarily when interventions push representations off the model's valid-generation manifold. Finally, we introduce a new steering approach SPLIT guided by this analysis that improves preference while better preserving utility. Code is available at https://github.com/zjunlp/EasyEdit/blob/main/examples/SPLIT.md.

There has been an increasing research interest in developing specialized dialogue systems that can offer mental health support. However, gathering large-scale and real-life multi-turn conversations for mental health support poses challenges due to the sensitivity of personal information, as well as the time and cost involved. To address these issues, we introduce the SMILE approach, an inclusive language expansion technique that employs ChatGPT to extend public single-turn dialogues into multi-turn ones. Our research first presents a preliminary exploratory study that validates the effectiveness of the SMILE approach. Furthermore, we conduct a comprehensive and systematic contrastive analysis of datasets generated with and without the SMILE approach, demonstrating that the SMILE method results in a large-scale, diverse, and close-to-real-life multi-turn mental health support conversation corpus, including dialog topics, lexical and semantic features. Finally, we use the collected corpus (SMILECHAT) to develop a more effective dialogue system that offers emotional support and constructive suggestions in multi-turn conversations for mental health support.

A common technique for aligning large language models (LLMs) relies on acquiring human preferences by comparing multiple generations conditioned on a fixed context. This only leverages the pairwise comparisons when the generations are placed in an identical context. However, such conditional rankings often fail to capture the complex and multidimensional aspects of human preferences. In this work, we revisit the traditional paradigm of preference acquisition and propose a new axis that is based on eliciting preferences jointly over the instruction-response pairs. While prior preference optimizations are designed for conditional ranking protocols (e.g., DPO), our proposed preference acquisition protocol introduces DOVE, a new preference optimization objective that upweights the joint probability of the chosen instruction-response pair over the rejected instruction-response pair. Interestingly, we find that the LLM trained with joint instruction-response preference data using DOVE outperforms the LLM trained with DPO by 5.2% and 3.3% win-rate for the summarization and open-ended dialogue datasets, respectively. Our findings reveal that joint preferences over instruction and response pairs can significantly enhance the alignment of LLMs by tapping into a broader spectrum of human preference elicitation. The data and code is available at https://github.com/Hritikbansal/dove.

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.

Preference alignment has emerged as an effective strategy to enhance the performance of Multimodal Large Language Models (MLLMs) following supervised fine-tuning. While existing preference alignment methods predominantly target hallucination factors, they overlook the factors essential for multi-modal comprehension capabilities, often narrowing their improvements on hallucination mitigation. To bridge this gap, we propose Instruction-oriented Preference Alignment (IPA), a scalable framework designed to automatically construct alignment preferences grounded in instruction fulfillment efficacy. Our method involves an automated preference construction coupled with a dedicated verification process that identifies instruction-oriented factors, avoiding significant variability in response representations. Additionally, IPA incorporates a progressive preference collection pipeline, further recalling challenging samples through model self-evolution and reference-guided refinement. Experiments conducted on Qwen2VL-7B demonstrate IPA's effectiveness across multiple benchmarks, including hallucination evaluation, visual question answering, and text understanding tasks, highlighting its capability to enhance general comprehension.

As Large Language Models (LLMs) become deeply integrated into human life and increasingly influence decision-making, it's crucial to evaluate whether and to what extent they exhibit subjective preferences, opinions, and beliefs. These tendencies may stem from biases within the models, which may shape their behavior, influence the advice and recommendations they offer to users, and potentially reinforce certain viewpoints. This paper presents the Preference, Opinion, and Belief survey (POBs), a benchmark developed to assess LLMs' subjective inclinations across societal, cultural, ethical, and personal domains. We applied our benchmark to evaluate leading open- and closed-source LLMs, measuring desired properties such as reliability, neutrality, and consistency. In addition, we investigated the effect of increasing the test-time compute, through reasoning and self-reflection mechanisms, on those metrics. While effective in other tasks, our results show that these mechanisms offer only limited gains in our domain. Furthermore, we reveal that newer model versions are becoming less consistent and more biased toward specific viewpoints, highlighting a blind spot and a concerning trend. POBS: https://ibm.github.io/POBS

Large language models (LLMs) increasingly store user preferences in persistent memory to support personalization across interactions. However, in third-party communication settings governed by social and institutional norms, some user preferences may be inappropriate to apply. We introduce BenchPreS, which evaluates whether memory-based user preferences are appropriately applied or suppressed across communication contexts. Using two complementary metrics, Misapplication Rate (MR) and Appropriate Application Rate (AAR), we find even frontier LLMs struggle to apply preferences in a context-sensitive manner. Models with stronger preference adherence exhibit higher rates of over-application, and neither reasoning capability nor prompt-based defenses fully resolve this issue. These results suggest current LLMs treat personalized preferences as globally enforceable rules rather than as context-dependent normative signals.

Large language models (LLMs) show promise in drafting responses to patient portal messages, yet their integration into clinical workflows raises various concerns, including whether they would actually save clinicians time and effort in their portal workload. We investigate LLM alignment with individual clinicians through a comprehensive evaluation of the patient message response drafting task. We develop a novel taxonomy of thematic elements in clinician responses and propose a novel evaluation framework for assessing clinician editing load of LLM-drafted responses at both content and theme levels. We release an expert-annotated dataset and conduct large-scale evaluations of local and commercial LLMs using various adaptation techniques including thematic prompting, retrieval-augmented generation, supervised fine-tuning, and direct preference optimization. Our results reveal substantial epistemic uncertainty in aligning LLM drafts with clinician responses. While LLMs demonstrate capability in drafting certain thematic elements, they struggle with clinician-aligned generation in other themes, particularly question asking to elicit further information from patients. Theme-driven adaptation strategies yield improvements across most themes. Our findings underscore the necessity of adapting LLMs to individual clinician preferences to enable reliable and responsible use in patient-clinician communication workflows.

Despite advancements in Large Language Model (LLM) alignment, understanding the reasons behind LLM preferences remains crucial for bridging the gap between desired and actual behavior. LLMs often exhibit biases or tendencies that diverge from human preferences, such as favoring certain writing styles or producing overly verbose outputs. However, current methods for evaluating preference alignment often lack explainability, relying on coarse-grained comparisons. To address this, we introduce PROFILE (PRObing Factors of InfLuence for Explainability), a novel framework that uncovers and quantifies the influence of specific factors driving preferences. PROFILE's factor level analysis explains the 'why' behind human-model alignment and misalignment, offering insights into the direction of model improvement. We apply PROFILE to analyze human and LLM preferences across three tasks: summarization, helpful response generation, and document-based question-answering. Our factor level analysis reveals a substantial discrepancy between human and LLM preferences in generation tasks, whereas LLMs show strong alignment with human preferences in evaluation tasks. We demonstrate how leveraging factor level insights, including addressing misaligned factors or exploiting the generation-evaluation gap, can improve alignment with human preferences. This work underscores the importance of explainable preference analysis and highlights PROFILE's potential to provide valuable training signals, driving further improvements in human-model alignment.

Large Language Models (LLMs) present immense potential in the medical field, yet concerns over data privacy, regulatory compliance, and model stability restrict their widespread adoption. Although the distillation of high-performing closed-source LLMs has proven effective for general tasks, their application in healthcare is limited due to reduced domain knowledge and remnants of alignment behavior hindering clinical tasks. To address these challenges, we propose Dialogue-Based Knowledge Encoding (DBKE). DBKE enhances models' implicit knowledge base and primes them for conversational recall, augmenting their conversational capabilities and enabling a soft alignment for subsequent use cases. By transforming dense academic source text into synthetic dialogue, DBKE broadens the model's knowledge base and enables a soft alignment that guides downstream behaviours. We present Clinical Camel, an open-source, healthcare-focused conversational model, to showcase the effectiveness of DBKE. Clinical Camel outperforms GPT-3.5 on the United States Medical Licensing Examination (USMLE) Step 1 and Step 3 with scores of 53.2 % and 58.2 %, respectively, compared to GPT-3.5's scores of 36.1 % and 55.7 %. Clinical Camel adeptly handles multi-stage clinical case problems, provides adaptive counseling, and generates clinical notes. However, it is prone to hallucinations, which pose a significant obstacle in safety-critical settings. The performance of Clinical Camel underscores the importance of continued research and development of open-source models for the safe and effective integration of LLMs in healthcare settings.

Large language models (LLMs) have traditionally been aligned through one-size-fits-all approaches that assume uniform human preferences, fundamentally overlooking the diversity in user values and needs. This paper introduces a comprehensive framework for scalable personalized alignment of LLMs. We establish a systematic preference space characterizing psychological and behavioral dimensions, alongside diverse persona representations for robust preference inference in real-world scenarios. Building upon this foundation, we introduce AlignX, a large-scale dataset of over 1.3 million personalized preference examples, and develop two complementary alignment approaches: in-context alignment directly conditioning on persona representations and preference-bridged alignment modeling intermediate preference distributions. Extensive experiments demonstrate substantial improvements over existing methods, with an average 17.06\% accuracy gain across four benchmarks while exhibiting a strong adaptation capability to novel preferences, robustness to limited user data, and precise preference controllability. These results validate our approach toward user-adaptive AI systems.

Human feedback plays a central role in the alignment of Large Language Models (LLMs). However, open questions remain about the methods (how), domains (where), people (who) and objectives (to what end) of human feedback collection. To navigate these questions, we introduce PRISM, a new dataset which maps the sociodemographics and stated preferences of 1,500 diverse participants from 75 countries, to their contextual preferences and fine-grained feedback in 8,011 live conversations with 21 LLMs. PRISM contributes (i) wide geographic and demographic participation in human feedback data; (ii) two census-representative samples for understanding collective welfare (UK and US); and (iii) individualised feedback where every rating is linked to a detailed participant profile, thus permitting exploration of personalisation and attribution of sample artefacts. We focus on collecting conversations that centre subjective and multicultural perspectives on value-laden and controversial topics, where we expect the most interpersonal and cross-cultural disagreement. We demonstrate the usefulness of PRISM via three case studies of dialogue diversity, preference diversity, and welfare outcomes, showing that it matters which humans set alignment norms. As well as offering a rich community resource, we advocate for broader participation in AI development and a more inclusive approach to technology design.

Constrained by the cost and ethical concerns of involving real seekers in AI-driven mental health, researchers develop LLM-based conversational agents (CAs) with tailored configurations, such as profiles, symptoms, and scenarios, to simulate seekers. While these efforts advance AI in mental health, achieving more realistic seeker simulation remains hindered by two key challenges: dynamic evolution and multi-session memory. Seekers' mental states often fluctuate during counseling, which typically spans multiple sessions. To address this, we propose AnnaAgent, an emotional and cognitive dynamic agent system equipped with tertiary memory. AnnaAgent incorporates an emotion modulator and a complaint elicitor trained on real counseling dialogues, enabling dynamic control of the simulator's configurations. Additionally, its tertiary memory mechanism effectively integrates short-term and long-term memory across sessions. Evaluation results, both automated and manual, demonstrate that AnnaAgent achieves more realistic seeker simulation in psychological counseling compared to existing baselines. The ethically reviewed and screened code can be found on https://github.com/sci-m-wang/AnnaAgent.

We propose DISC-MedLLM, a comprehensive solution that leverages Large Language Models (LLMs) to provide accurate and truthful medical response in end-to-end conversational healthcare services. To construct high-quality Supervised Fine-Tuning (SFT) datasets, we employ three strategies: utilizing medical knowledge-graphs, reconstructing real-world dialogues, and incorporating human-guided preference rephrasing. These datasets are instrumental in training DISC-MedLLM, surpassing existing medical LLMs in both single-turn and multi-turn consultation scenarios. Extensive experimental results demonstrate the effectiveness of the proposed model in bridging the gap between general language models and real-world medical consultation. Additionally, we release the constructed dataset and model weights to further contribute to research and development. Further details and resources can be found at https://github.com/FudanDISC/DISC-MedLLM

Recently, there has been significant interest in replacing the reward model in Reinforcement Learning with Human Feedback (RLHF) methods for Large Language Models (LLMs), such as Direct Preference Optimization (DPO) and its variants. These approaches commonly use a binary cross-entropy mechanism on pairwise samples, i.e., minimizing and maximizing the loss based on preferred or dis-preferred responses, respectively. However, while this training strategy omits the reward model, it also overlooks the varying preference degrees within different responses. We hypothesize that this is a key factor hindering LLMs from sufficiently understanding human preferences. To address this problem, we propose a novel Self-supervised Preference Optimization (SPO) framework, which constructs a self-supervised preference degree loss combined with the alignment loss, thereby helping LLMs improve their ability to understand the degree of preference. Extensive experiments are conducted on two widely used datasets of different tasks. The results demonstrate that SPO can be seamlessly integrated with existing preference optimization methods and significantly boost their performance to achieve state-of-the-art performance. We also conduct detailed analyses to offer comprehensive insights into SPO, which verifies its effectiveness. The code is available at https://github.com/lijian16/SPO.

Multimodal large language models (MLLMs) have achieved remarkable performance on complex tasks with multimodal context. However, it is still understudied whether they exhibit modality preference when processing multimodal contexts. To study this question, we first build a MC\textsuperscript{2} benchmark under controlled evidence conflict scenarios to systematically evaluate modality preference, which is the tendency to favor one modality over another when making decisions based on multimodal conflicting evidence. Our extensive evaluation reveals that all 18 tested MLLMs generally demonstrate clear modality bias, and modality preference can be influenced by external interventions. An in-depth analysis reveals that the preference direction can be captured within the latent representations of MLLMs. Built on this, we propose a probing and steering method based on representation engineering to explicitly control modality preference without additional fine-tuning or carefully crafted prompts. Our method effectively amplifies modality preference toward a desired direction and applies to downstream tasks such as hallucination mitigation and multimodal machine translation, yielding promising improvements.

Pre-trained Language Models (LMs) exhibit strong zero-shot and in-context learning capabilities; however, their behaviors are often difficult to control. By utilizing Reinforcement Learning from Human Feedback (RLHF), it is possible to fine-tune unsupervised LMs to follow instructions and produce outputs that reflect human preferences. Despite its benefits, RLHF has been shown to potentially harm a language model's reasoning capabilities and introduce artifacts such as hallucinations where the model may fabricate facts. To address this issue we introduce Direct Preference Heads (DPH), a fine-tuning framework that enables LMs to learn human preference signals through an auxiliary reward head without directly affecting the output distribution of the language modeling head. We perform a theoretical analysis of our objective function and find strong ties to Conservative Direct Preference Optimization (cDPO). Finally we evaluate our models on GLUE, RACE, and the GPT4All evaluation suite and demonstrate that our method produces models which achieve higher scores than those fine-tuned with Supervised Fine-Tuning (SFT) or Direct Preference Optimization (DPO) alone.

As AI chatbots become ubiquitous, voice interaction presents a compelling way to enable rapid, high-bandwidth communication for both semantic and social signals. This has driven research into Large Audio Models (LAMs) to power voice-native experiences. However, aligning LAM development with user goals requires a clear understanding of user needs and preferences to establish reliable progress metrics. This study addresses these challenges by introducing an interactive approach to evaluate LAMs and collecting 7,500 LAM interactions from 484 participants. Through topic modeling of user queries, we identify primary use cases for audio interfaces. We then analyze user preference rankings and qualitative feedback to determine which models best align with user needs. Finally, we evaluate how static benchmarks predict interactive performance - our analysis reveals no individual benchmark strongly correlates with interactive results (tau leq 0.33 for all benchmarks). While combining multiple coarse-grained features yields modest predictive power (R^2=0.30), only two out of twenty datasets on spoken question answering and age prediction show significantly positive correlations. This suggests a clear need to develop LAM evaluations that better correlate with user preferences.

Reinforcement learning from human feedback (RLHF) has become a pivot technique in aligning large language models (LLMs) with human preferences. In RLHF practice, preference data plays a crucial role in bridging human proclivity and LLMs. However, the scarcity of diverse, naturalistic datasets of human preferences on LLM outputs at scale poses a great challenge to RLHF as well as feedback learning research within the open-source community. Current preference datasets, either proprietary or limited in size and prompt variety, result in limited RLHF adoption in open-source models and hinder further exploration. In this study, we propose ULTRAFEEDBACK, a large-scale, high-quality, and diversified preference dataset designed to overcome these limitations and foster RLHF development. To create ULTRAFEEDBACK, we compile a diverse array of instructions and models from multiple sources to produce comparative data. We meticulously devise annotation instructions and employ GPT-4 to offer detailed feedback in both numerical and textual forms. ULTRAFEEDBACK establishes a reproducible and expandable preference data construction pipeline, serving as a solid foundation for future RLHF and feedback learning research. Utilizing ULTRAFEEDBACK, we train various models to demonstrate its effectiveness, including the reward model UltraRM, chat language model UltraLM-13B-PPO, and critique model UltraCM. Experimental results indicate that our models outperform existing open-source models, achieving top performance across multiple benchmarks. Our data and models are available at https://github.com/thunlp/UltraFeedback.

Personalization of Large Language Models (LLMs) often assumes users hold static preferences that reflect globally in all tasks. In reality, humans hold dynamic preferences that change depending on the context. As users interact with an LLM in various contexts, they naturally reveal their contextual preferences, which a model must infer and apply in future contexts to ensure alignment. To assess this, we introduce CUPID, a benchmark of 756 human-curated interaction session histories between users and LLM-based chat assistants. In each interaction session, the user provides a request in a specific context and expresses their preference through multi-turn feedback. Given a new user request and prior interaction sessions, our benchmark assesses whether LLMs can infer the preference relevant to this request and generate a response that satisfies this preference. With CUPID, we evaluated 10 open and proprietary LLMs, revealing that state-of-the-art LLMs struggle to infer preferences from multi-turn interactions and fail to discern what previous context is relevant to a new request -- under 50% precision and 65% recall. Our work highlights the need to advance LLM capabilities for more contextually personalized interactions and proposes CUPID as a resource to drive these improvements.

RLHF has emerged as a predominant approach for aligning artificial intelligence systems with human preferences, demonstrating exceptional and measurable efficacy in instruction following tasks; however, it exhibits insufficient compliance capabilities when confronted with complex multi-instruction tasks. Conventional approaches rely heavily on human annotation or more sophisticated large language models, thereby introducing substantial resource expenditure or potential bias concerns. Meanwhile, alternative synthetic methods that augment standard preference datasets often compromise the model's semantic quality. Our research identifies a critical oversight in existing techniques, which predominantly focus on comparing responses while neglecting valuable latent signals embedded within prompt inputs, and which only focus on preference disparities at the intra-sample level, while neglecting to account for the inter-sample level preference differentials that exist among preference data. To leverage these previously neglected indicators, we propose a novel Multi-level Aware Preference Learning (MAPL) framework, capable of enhancing multi-instruction capabilities. Specifically, for any given response in original preference data pairs, we construct varied prompts with a preference relation under different conditions, in order to learn intra-sample level preference disparities. Furthermore, for any given original preference pair, we synthesize multi-instruction preference pairs to capture preference discrepancies at the inter-sample level. Building on the two datasets constructed above, we consequently devise two sophisticated training objective functions. Subsequently, our framework integrates seamlessly into both Reward Modeling and Direct Preference Optimization paradigms. Through rigorous evaluation across multiple benchmarks, we empirically validate the efficacy of our framework.

Preference alignment has become a crucial component in enhancing the performance of Large Language Models (LLMs), yet its impact in Multimodal Large Language Models (MLLMs) remains comparatively underexplored. Similar to language models, MLLMs for image understanding tasks encounter challenges like hallucination. In MLLMs, hallucination can occur not only by stating incorrect facts but also by producing responses that are inconsistent with the image content. A primary objective of alignment for MLLMs is to encourage these models to align responses more closely with image information. Recently, multiple works have introduced preference datasets for MLLMs and examined different alignment methods, including Direct Preference Optimization (DPO) and Proximal Policy Optimization (PPO). However, due to variations in datasets, base model types, and alignment methods, it remains unclear which specific elements contribute most significantly to the reported improvements in these works. In this paper, we independently analyze each aspect of preference alignment in MLLMs. We start by categorizing the alignment algorithms into two groups, offline (such as DPO), and online (such as online-DPO), and show that combining offline and online methods can improve the performance of the model in certain scenarios. We review a variety of published multimodal preference datasets and discuss how the details of their construction impact model performance. Based on these insights, we introduce a novel way of creating multimodal preference data called Bias-Driven Hallucination Sampling (BDHS) that needs neither additional annotation nor external models, and show that it can achieve competitive performance to previously published alignment work for multimodal models across a range of benchmarks.

Aligning Large Language Models (LLMs) with general human preferences has been proved crucial in improving the interaction quality between LLMs and human. However, human values are inherently diverse among different individuals, making it insufficient to align LLMs solely with general preferences. To address this, personalizing LLMs according to individual feedback emerges as a promising solution. Nonetheless, this approach presents challenges in terms of the efficiency of alignment algorithms. In this work, we introduce a flexible paradigm for individual preference alignment. Our method fundamentally improves efficiency by disentangling preference representation from text generation in LLMs. We validate our approach across multiple text generation tasks and demonstrate that it can produce aligned quality as well as or better than PEFT-based methods, while reducing additional training time for each new individual preference by 80% to 90% in comparison with them.

Reinforcement learning from human feedback (RLHF) has emerged as the primary method for aligning large language models (LLMs) with human preferences. While it enables LLMs to achieve human-level alignment, it often incurs significant computational and financial costs due to its reliance on training external reward models or human-labeled preferences. In this work, we propose Implicit Preference Optimization (IPO), an alternative approach that leverages generative LLMs as preference classifiers, thereby reducing the dependence on external human feedback or reward models to obtain preferences. We conduct a comprehensive evaluation on the preference classification ability of LLMs using RewardBench, assessing models across different sizes, architectures, and training levels to validate our hypothesis. Furthermore, we investigate the self-improvement capabilities of LLMs by generating multiple responses for a given instruction and employing the model itself as a preference classifier for Direct Preference Optimization (DPO)-based training. Our findings demonstrate that models trained through IPO achieve performance comparable to those utilizing state-of-the-art reward models for obtaining preferences.

While finetuning language models from pairwise preferences has proven remarkably effective, the underspecified nature of natural language presents critical challenges. Direct preference feedback is uninterpretable, difficult to provide where multidimensional criteria may apply, and often inconsistent, either because it is based on incomplete instructions or provided by diverse principals. To address these challenges, we consider the two-step preference modeling procedure that first resolves the under-specification by selecting a context, and then evaluates preference with respect to the chosen context. We decompose reward modeling error according to these two steps, which suggests that supervising context in addition to context-specific preference may be a viable approach to aligning models with diverse human preferences. For this to work, the ability of models to evaluate context-specific preference is critical. To this end, we contribute context-conditioned preference datasets and accompanying experiments that investigate the ability of language models to evaluate context-specific preference. We use our datasets to (1) show that existing preference models benefit from, but fail to fully consider, added context, (2) finetune a context-aware reward model with context-specific performance exceeding that of GPT-4 and Llama 3 70B on tested datasets, and (3) investigate the value of context-aware preference modeling.

Large language models (LLMs) have emerged as powerful and general solutions to many natural language tasks. However, many of the most important applications of language generation are interactive, where an agent has to talk to a person to reach a desired outcome. For example, a teacher might try to understand their student's current comprehension level to tailor their instruction accordingly, and a travel agent might ask questions of their customer to understand their preferences in order to recommend activities they might enjoy. LLMs trained with supervised fine-tuning or "single-step" RL, as with standard RLHF, might struggle which tasks that require such goal-directed behavior, since they are not trained to optimize for overall conversational outcomes after multiple turns of interaction. In this work, we explore a new method for adapting LLMs with RL for such goal-directed dialogue. Our key insight is that, though LLMs might not effectively solve goal-directed dialogue tasks out of the box, they can provide useful data for solving such tasks by simulating suboptimal but human-like behaviors. Given a textual description of a goal-directed dialogue task, we leverage LLMs to sample diverse synthetic rollouts of hypothetical in-domain human-human interactions. Our algorithm then utilizes this dataset with offline reinforcement learning to train an interactive conversational agent that can optimize goal-directed objectives over multiple turns. In effect, the LLM produces examples of possible interactions, and RL then processes these examples to learn to perform more optimal interactions. Empirically, we show that our proposed approach achieves state-of-the-art performance in various goal-directed dialogue tasks that include teaching and preference elicitation.

Large Language Models (LLMs), such as GPT3.5, have exhibited remarkable proficiency in comprehending and generating natural language. However, their unpersonalized generation paradigm may result in suboptimal user-specific outcomes. Typically, users converse differently based on their knowledge and preferences. This necessitates the task of enhancing user-oriented LLM which remains unexplored. While one can fully train an LLM for this objective, the resource consumption is unaffordable. Prior research has explored memory-based methods to store and retrieve knowledge to enhance generation without retraining for new queries. However, we contend that a mere memory module is inadequate to comprehend a user's preference, and fully training an LLM can be excessively costly. In this study, we propose a novel computational bionic memory mechanism, equipped with a parameter-efficient fine-tuning schema, to personalize LLMs. Our extensive experimental results demonstrate the effectiveness and superiority of the proposed approach. To encourage further research into this area, we are releasing a new conversation dataset generated entirely by LLM based on an open-source medical corpus, as well as our implementation code.

Human preference plays a crucial role in the refinement of large language models (LLMs). However, collecting human preference feedback is costly and most existing datasets neglect the correlation between personalization and preferences. To address this issue, we introduce Fair-PP, a synthetic dataset of personalized preferences targeting social equity, derived from real-world social survey data, which includes 28 social groups, 98 equity topics, and 5 personal preference dimensions. Leveraging GPT-4o-mini, we engage in role-playing based on seven representative persona portrayals guided by existing social survey data, yielding a total of 238,623 preference records. Through Fair-PP, we also contribute (i) An automated framework for generating preference data, along with a more fine-grained dataset of personalized preferences; (ii) analysis of the positioning of the existing mainstream LLMs across five major global regions within the personalized preference space; and (iii) a sample reweighting method for personalized preference alignment, enabling alignment with a target persona while maximizing the divergence from other personas. Empirical experiments show our method outperforms the baselines.

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%

Mental illness remains one of the most critical public health issues. Despite its importance, many mental health professionals highlight a disconnect between their training and actual real-world patient practice. To help bridge this gap, we propose PATIENT-{\Psi}, a novel patient simulation framework for cognitive behavior therapy (CBT) training. To build PATIENT-{\Psi}, we construct diverse patient cognitive models based on CBT principles and use large language models (LLMs) programmed with these cognitive models to act as a simulated therapy patient. We propose an interactive training scheme, PATIENT-{\Psi}-TRAINER, for mental health trainees to practice a key skill in CBT -- formulating the cognitive model of the patient -- through role-playing a therapy session with PATIENT-{\Psi}. To evaluate PATIENT-{\Psi}, we conducted a comprehensive user study of 13 mental health trainees and 20 experts. The results demonstrate that practice using PATIENT-{\Psi}-TRAINER enhances the perceived skill acquisition and confidence of the trainees beyond existing forms of training such as textbooks, videos, and role-play with non-patients. Based on the experts' perceptions, PATIENT-{\Psi} is perceived to be closer to real patient interactions than GPT-4, and PATIENT-{\Psi}-TRAINER holds strong promise to improve trainee competencies. Our code and data are released at https://github.com/ruiyiw/patient-psi.

Large Language Models (LLMs) are increasingly used as chatbots, yet their ability to personalize responses to user preferences remains limited. We introduce PrefEval, a benchmark for evaluating LLMs' ability to infer, memorize and adhere to user preferences in a long-context conversational setting. PrefEval comprises 3,000 manually curated user preference and query pairs spanning 20 topics. PrefEval contains user personalization or preference information in both explicit and implicit forms, and evaluates LLM performance using a generation and a classification task. With PrefEval, we evaluated the aforementioned preference following capabilities of 10 open-source and proprietary LLMs in multi-session conversations with varying context lengths up to 100k tokens. We benchmark with various prompting, iterative feedback, and retrieval-augmented generation methods. Our benchmarking effort reveals that state-of-the-art LLMs face significant challenges in proactively following users' preferences during conversations. In particular, in zero-shot settings, preference following accuracy falls below 10% at merely 10 turns (~3k tokens) across most evaluated models. Even with advanced prompting and retrieval methods, preference following still deteriorates in long-context conversations. Furthermore, we show that fine-tuning on PrefEval significantly improves performance. We believe PrefEval serves as a valuable resource for measuring, understanding, and enhancing LLMs' preference following abilities, paving the way for personalized conversational agents. Our code and dataset are available at https://prefeval.github.io/.

Human preference alignment is critical in building powerful and reliable large language models (LLMs). However, current methods either ignore the multi-dimensionality of human preferences (e.g. helpfulness and harmlessness) or struggle with the complexity of managing multiple reward models. To address these issues, we propose Sequential Preference Optimization (SPO), a method that sequentially fine-tunes LLMs to align with multiple dimensions of human preferences. SPO avoids explicit reward modeling, directly optimizing the models to align with nuanced human preferences. We theoretically derive closed-form optimal SPO policy and loss function. Gradient analysis is conducted to show how SPO manages to fine-tune the LLMs while maintaining alignment on previously optimized dimensions. Empirical results on LLMs of different size and multiple evaluation datasets demonstrate that SPO successfully aligns LLMs across multiple dimensions of human preferences and significantly outperforms the baselines.

Mental health risk is a critical global public health challenge, necessitating innovative and reliable assessment methods. With the development of large language models (LLMs), they stand out to be a promising tool for explainable mental health care applications. Nevertheless, existing approaches predominantly rely on subjective textual mental records, which can be distorted by inherent mental uncertainties, leading to inconsistent and unreliable predictions. To address these limitations, this paper introduces ProMind-LLM. We investigate an innovative approach integrating objective behavior data as complementary information alongside subjective mental records for robust mental health risk assessment. Specifically, ProMind-LLM incorporates a comprehensive pipeline that includes domain-specific pretraining to tailor the LLM for mental health contexts, a self-refine mechanism to optimize the processing of numerical behavioral data, and causal chain-of-thought reasoning to enhance the reliability and interpretability of its predictions. Evaluations of two real-world datasets, PMData and Globem, demonstrate the effectiveness of our proposed methods, achieving substantial improvements over general LLMs. We anticipate that ProMind-LLM will pave the way for more dependable, interpretable, and scalable mental health case solutions.

Effective conversational agents must be able to personalize their behavior to suit a user's preferences, personality, and attributes, whether they are assisting with writing tasks or operating in domains like education or healthcare. Current training methods like Reinforcement Learning from Human Feedback (RLHF) prioritize helpfulness and safety but fall short in fostering truly empathetic, adaptive, and personalized interactions. Traditional approaches to personalization often rely on extensive user history, limiting their effectiveness for new or context-limited users. To overcome these limitations, we propose to incorporate an intrinsic motivation to improve the conversational agents's model of the user as an additional reward alongside multi-turn RLHF. This reward mechanism encourages the agent to actively elicit user traits by optimizing conversations to increase the accuracy of its user model. Consequently, the policy agent can deliver more personalized interactions through obtaining more information about the user. We applied our method both education and fitness settings, where LLMs teach concepts or recommend personalized strategies based on users' hidden learning style or lifestyle attributes. Using LLM-simulated users, our approach outperformed a multi-turn RLHF baseline in revealing information about the users' preferences, and adapting to them.

Automated evaluation leveraging large language models (LLMs), commonly referred to as LLM evaluators or LLM-as-a-judge, has been widely used in measuring the performance of dialogue systems. However, the self-preference bias in LLMs has posed significant risks, including promoting specific styles or policies intrinsic to the LLMs. Despite the importance of this issue, there is a lack of established methods to measure the self-preference bias quantitatively, and its underlying causes are poorly understood. In this paper, we introduce a novel quantitative metric to measure the self-preference bias. Our experimental results demonstrate that GPT-4 exhibits a significant degree of self-preference bias. To explore the causes, we hypothesize that LLMs may favor outputs that are more familiar to them, as indicated by lower perplexity. We analyze the relationship between LLM evaluations and the perplexities of outputs. Our findings reveal that LLMs assign significantly higher evaluations to outputs with lower perplexity than human evaluators, regardless of whether the outputs were self-generated. This suggests that the essence of the bias lies in perplexity and that the self-preference bias exists because LLMs prefer texts more familiar to them.

The remarkable abilities of large language models (LLMs) like GPT-4 partially stem from post-training processes like Reinforcement Learning from Human Feedback (RLHF) involving human preferences encoded in a reward model. However, these reward models (RMs) often lack direct knowledge of why, or under what principles, the preferences annotations were made. In this study, we identify principles that guide RMs to better align with human preferences, and then develop an axiomatic framework to generate a rich variety of preference signals to uphold them. We use these axiomatic signals to train a model for scoring answers to longform questions. Our approach yields a Preference Model with only about 220M parameters that agrees with gold human-annotated preference labels more often than GPT-4. The contributions of this work include: training a standalone preference model that can score human- and LLM-generated answers on the same scale; developing an axiomatic framework for generating training data pairs tailored to certain principles; and showing that a small amount of axiomatic signals can help small models outperform GPT-4 in preference scoring. We release our model on huggingface: https://huggingface.co/corbyrosset/axiomatic_preference_model

A Conversational Recommender System (CRS) offers increased transparency and control to users by enabling them to engage with the system through a real-time multi-turn dialogue. Recently, Large Language Models (LLMs) have exhibited an unprecedented ability to converse naturally and incorporate world knowledge and common-sense reasoning into language understanding, unlocking the potential of this paradigm. However, effectively leveraging LLMs within a CRS introduces new technical challenges, including properly understanding and controlling a complex conversation and retrieving from external sources of information. These issues are exacerbated by a large, evolving item corpus and a lack of conversational data for training. In this paper, we provide a roadmap for building an end-to-end large-scale CRS using LLMs. In particular, we propose new implementations for user preference understanding, flexible dialogue management and explainable recommendations as part of an integrated architecture powered by LLMs. For improved personalization, we describe how an LLM can consume interpretable natural language user profiles and use them to modulate session-level context. To overcome conversational data limitations in the absence of an existing production CRS, we propose techniques for building a controllable LLM-based user simulator to generate synthetic conversations. As a proof of concept we introduce RecLLM, a large-scale CRS for YouTube videos built on LaMDA, and demonstrate its fluency and diverse functionality through some illustrative example conversations.

Mental health has attracted substantial attention in recent years and LLM can be an effective technology for alleviating this problem owing to its capability in text understanding and dialogue. However, existing research in this domain often suffers from limitations, such as training on datasets lacking crucial prior knowledge and evidence, and the absence of comprehensive evaluation methods. In this paper, we propose a specialized psychological large language model (LLM), named PsycoLLM, trained on a proposed high-quality psychological dataset, including single-turn QA, multi-turn dialogues enriched with prior knowledge and knowledge-based QA. Additionally, to compare the performance of PsycoLLM with other LLMs, we develop a comprehensive psychological benchmark based on authoritative psychological counseling examinations in China, which includes assessments of professional ethics, theoretical proficiency, and case analysis. The experimental results on the benchmark illustrates the effectiveness of PsycoLLM, which demonstrates superior performance compared to other LLMs.

Large Language Model (LLM) training often optimizes for preference alignment, rewarding outputs that are perceived as helpful and interaction-friendly. However, this preference-oriented objective can be exploited: manipulative prompts can steer responses toward user-appeasing agreement and away from truth-oriented correction. In this work, we investigate whether aligned models are vulnerable to Preference-Undermining Attacks (PUA), a class of manipulative prompting strategies designed to exploit the model's desire to please user preferences at the expense of truthfulness. We propose a diagnostic methodology that provides a finer-grained and more directive analysis than aggregate benchmark scores, using a factorial evaluation framework to decompose prompt-induced shifts into interpretable effects of system objectives (truth- vs. preference-oriented) and PUA-style dialogue factors (directive control, personal derogation, conditional approval, reality denial) within a controlled 2 times 2^4 design. Surprisingly, more advanced models are sometimes more susceptible to manipulative prompts. Beyond the dominant reality-denial factor, we observe model-specific sign reversals and interactions with PUA-style factors, suggesting tailored defenses rather than uniform robustness. These findings offer a novel, reproducible factorial evaluation methodology that provides finer-grained diagnostics for post-training processes like RLHF, enabling better trade-offs in the product iteration of LLMs by offering a more nuanced understanding of preference alignment risks and the impact of manipulative prompts.

The rapid advancement of Large Language Models (LLMs) has revolutionized the generation of emotional support conversations (ESC), offering scalable solutions with reduced costs and enhanced data privacy. This paper explores the role of personas in the creation of ESC by LLMs. Our research utilizes established psychological frameworks to measure and infuse persona traits into LLMs, which then generate dialogues in the emotional support scenario. We conduct extensive evaluations to understand the stability of persona traits in dialogues, examining shifts in traits post-generation and their impact on dialogue quality and strategy distribution. Experimental results reveal several notable findings: 1) LLMs can infer core persona traits, 2) subtle shifts in emotionality and extraversion occur, influencing the dialogue dynamics, and 3) the application of persona traits modifies the distribution of emotional support strategies, enhancing the relevance and empathetic quality of the responses. These findings highlight the potential of persona-driven LLMs in crafting more personalized, empathetic, and effective emotional support dialogues, which has significant implications for the future design of AI-driven emotional support systems.