Daily Papers

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

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.

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.

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.

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.

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

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.

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

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.

Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PatientSim, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PatientSim operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations. We evaluated eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3, was validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PatientSim provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare.

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.

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.

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.

VR simulation in Health Professions (HP) education demonstrates huge potential, but fixed learning content with little customization limits its application beyond lab environments. To address these limitations in the context of VR for patient communication training, we conducted a user-centered study involving semi-structured interviews with advanced HP students to understand their challenges in clinical communication training and perceptions of VR-based solutions. From this, we derived design insights emphasizing the importance of realistic scenarios, simple interactions, and unpredictable dialogues. Building on these insights, we developed the Virtual AI Patient Simulator (VAPS), a novel VR system powered by Large Language Models (LLMs) and Embodied Conversational Agents (ECAs), supporting dynamic and customizable patient interactions for immersive learning. We also provided an example of how clinical professors could use user-friendly design forms to create personalized scenarios that align with course objectives in VAPS and discuss future implications of integrating AI-driven technologies into VR education.

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.

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.

Large language models (LLMs) are increasingly used as simulated participants in social science experiments, but their behavior is often unstable and highly sensitive to design choices. Prior evaluations frequently conflate base-model capabilities with experimental instantiation, obscuring whether outcomes reflect the model itself or the agent setup. We instead frame participant simulation as an agent-design problem over full experimental protocols, where an agent is defined by a base model and a specification (e.g., participant attributes) that encodes behavioral assumptions. We introduce HUMANSTUDY-BENCH, a benchmark and execution engine that orchestrates LLM-based agents to reconstruct published human-subject experiments via a Filter--Extract--Execute--Evaluate pipeline, replaying trial sequences and running the original analysis pipeline in a shared runtime that preserves the original statistical procedures end to end. To evaluate fidelity at the level of scientific inference, we propose new metrics to quantify how much human and agent behaviors agree. We instantiate 12 foundational studies as an initial suite in this dynamic benchmark, spanning individual cognition, strategic interaction, and social psychology, and covering more than 6,000 trials with human samples ranging from tens to over 2,100 participants.

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.

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.

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.

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.

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.

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.

In this paper, we introduce a simulacrum of hospital called Agent Hospital that simulates the entire process of treating illness. All patients, nurses, and doctors are autonomous agents powered by large language models (LLMs). Our central goal is to enable a doctor agent to learn how to treat illness within the simulacrum. To do so, we propose a method called MedAgent-Zero. As the simulacrum can simulate disease onset and progression based on knowledge bases and LLMs, doctor agents can keep accumulating experience from both successful and unsuccessful cases. Simulation experiments show that the treatment performance of doctor agents consistently improves on various tasks. More interestingly, the knowledge the doctor agents have acquired in Agent Hospital is applicable to real-world medicare benchmarks. After treating around ten thousand patients (real-world doctors may take over two years), the evolved doctor agent achieves a state-of-the-art accuracy of 93.06% on a subset of the MedQA dataset that covers major respiratory diseases. This work paves the way for advancing the applications of LLM-powered agent techniques in medical scenarios.

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.

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.

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

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.

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.

Simulating Professions (SP) enables Large Language Models (LLMs) to emulate professional roles. However, comprehensive psychological and ethical evaluation in these contexts remains lacking. This paper introduces EMNLP, an Educator-role Moral and Normative LLMs Profiling framework for personality profiling, moral development stage measurement, and ethical risk under soft prompt injection. EMNLP extends existing scales and constructs 88 teacher-specific moral dilemmas, enabling profession-oriented comparison with human teachers. A targeted soft prompt injection set evaluates compliance and vulnerability in teacher SP. Experiments on 12 LLMs show teacher-role LLMs exhibit more idealized and polarized personalities than human teachers, excel in abstract moral reasoning, but struggle with emotionally complex situations. Models with stronger reasoning are more vulnerable to harmful prompt injection, revealing a paradox between capability and safety. The model temperature and other hyperparameters have limited influence except in some risk behaviors. This paper presents the first benchmark to assess ethical and psychological alignment of teacher-role LLMs for educational AI. Resources are available at https://e-m-n-l-p.github.io/.

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

In this work, we introduce MedAgentSim, an open-source simulated clinical environment with doctor, patient, and measurement agents designed to evaluate and enhance LLM performance in dynamic diagnostic settings. Unlike prior approaches, our framework requires doctor agents to actively engage with patients through multi-turn conversations, requesting relevant medical examinations (e.g., temperature, blood pressure, ECG) and imaging results (e.g., MRI, X-ray) from a measurement agent to mimic the real-world diagnostic process. Additionally, we incorporate self improvement mechanisms that allow models to iteratively refine their diagnostic strategies. We enhance LLM performance in our simulated setting by integrating multi-agent discussions, chain-of-thought reasoning, and experience-based knowledge retrieval, facilitating progressive learning as doctor agents interact with more patients. We also introduce an evaluation benchmark for assessing the LLM's ability to engage in dynamic, context-aware diagnostic interactions. While MedAgentSim is fully automated, it also supports a user-controlled mode, enabling human interaction with either the doctor or patient agent. Comprehensive evaluations in various simulated diagnostic scenarios demonstrate the effectiveness of our approach. Our code, simulation tool, and benchmark are available at https://medagentsim.netlify.app/.

The promise of human behavioral simulation--general-purpose computational agents that replicate human behavior across domains--could enable broad applications in policymaking and social science. We present a novel agent architecture that simulates the attitudes and behaviors of 1,052 real individuals--applying large language models to qualitative interviews about their lives, then measuring how well these agents replicate the attitudes and behaviors of the individuals that they represent. The generative agents replicate participants' responses on the General Social Survey 85% as accurately as participants replicate their own answers two weeks later, and perform comparably in predicting personality traits and outcomes in experimental replications. Our architecture reduces accuracy biases across racial and ideological groups compared to agents given demographic descriptions. This work provides a foundation for new tools that can help investigate individual and collective behavior.

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.

Social simulation is transforming traditional social science research by modeling human behavior through interactions between virtual individuals and their environments. With recent advances in large language models (LLMs), this approach has shown growing potential in capturing individual differences and predicting group behaviors. However, existing methods face alignment challenges related to the environment, target users, interaction mechanisms, and behavioral patterns. To this end, we introduce SocioVerse, an LLM-agent-driven world model for social simulation. Our framework features four powerful alignment components and a user pool of 10 million real individuals. To validate its effectiveness, we conducted large-scale simulation experiments across three distinct domains: politics, news, and economics. Results demonstrate that SocioVerse can reflect large-scale population dynamics while ensuring diversity, credibility, and representativeness through standardized procedures and minimal manual adjustments.

Large language models (LLMs) are revolutionizing education, with LLM-based agents playing a key role in simulating student behavior. A major challenge in student simulation is modeling the diverse learning patterns of students at various cognitive levels. However, current LLMs, typically trained as ``helpful assistants'', target at generating perfect responses. As a result, they struggle to simulate students with diverse cognitive abilities, as they often produce overly advanced answers, missing the natural imperfections that characterize student learning and resulting in unrealistic simulations. To address this issue, we propose a training-free framework for student simulation. We begin by constructing a cognitive prototype for each student using a knowledge graph, which captures their understanding of concepts from past learning records. This prototype is then mapped to new tasks to predict student performance. Next, we simulate student solutions based on these predictions and iteratively refine them using a beam search method to better replicate realistic mistakes. To validate our approach, we construct the Student\_100 dataset, consisting of 100 students working on Python programming and 5,000 learning records. Experimental results show that our method consistently outperforms baseline models, achieving 100% improvement in simulation accuracy.

Believable proxies of human behavior can empower interactive applications ranging from immersive environments to rehearsal spaces for interpersonal communication to prototyping tools. In this paper, we introduce generative agents--computational software agents that simulate believable human behavior. Generative agents wake up, cook breakfast, and head to work; artists paint, while authors write; they form opinions, notice each other, and initiate conversations; they remember and reflect on days past as they plan the next day. To enable generative agents, we describe an architecture that extends a large language model to store a complete record of the agent's experiences using natural language, synthesize those memories over time into higher-level reflections, and retrieve them dynamically to plan behavior. We instantiate generative agents to populate an interactive sandbox environment inspired by The Sims, where end users can interact with a small town of twenty five agents using natural language. In an evaluation, these generative agents produce believable individual and emergent social behaviors: for example, starting with only a single user-specified notion that one agent wants to throw a Valentine's Day party, the agents autonomously spread invitations to the party over the next two days, make new acquaintances, ask each other out on dates to the party, and coordinate to show up for the party together at the right time. We demonstrate through ablation that the components of our agent architecture--observation, planning, and reflection--each contribute critically to the believability of agent behavior. By fusing large language models with computational, interactive agents, this work introduces architectural and interaction patterns for enabling believable simulations of human behavior.

Traditional sociological research often relies on human participation, which, though effective, is expensive, challenging to scale, and with ethical concerns. Recent advancements in large language models (LLMs) highlight their potential to simulate human behavior, enabling the replication of individual responses and facilitating studies on many interdisciplinary studies. In this paper, we conduct a comprehensive survey of this field, illustrating the recent progress in simulation driven by LLM-empowered agents. We categorize the simulations into three types: (1) Individual Simulation, which mimics specific individuals or demographic groups; (2) Scenario Simulation, where multiple agents collaborate to achieve goals within specific contexts; and (3) Society Simulation, which models interactions within agent societies to reflect the complexity and variety of real-world dynamics. These simulations follow a progression, ranging from detailed individual modeling to large-scale societal phenomena. We provide a detailed discussion of each simulation type, including the architecture or key components of the simulation, the classification of objectives or scenarios and the evaluation method. Afterward, we summarize commonly used datasets and benchmarks. Finally, we discuss the trends across these three types of simulation. A repository for the related sources is at {https://github.com/FudanDISC/SocialAgent}.

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.

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%

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.

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.

Human interactions are deeply rooted in the interplay of thoughts, beliefs, and desires made possible by Theory of Mind (ToM): our cognitive ability to understand the mental states of ourselves and others. Although ToM may come naturally to us, emulating it presents a challenge to even the most advanced Large Language Models (LLMs). Recent improvements to LLMs' reasoning capabilities from simple yet effective prompting techniques such as Chain-of-Thought have seen limited applicability to ToM. In this paper, we turn to the prominent cognitive science theory "Simulation Theory" to bridge this gap. We introduce SimToM, a novel two-stage prompting framework inspired by Simulation Theory's notion of perspective-taking. To implement this idea on current ToM benchmarks, SimToM first filters context based on what the character in question knows before answering a question about their mental state. Our approach, which requires no additional training and minimal prompt-tuning, shows substantial improvement over existing methods, and our analysis reveals the importance of perspective-taking to Theory-of-Mind capabilities. Our findings suggest perspective-taking as a promising direction for future research into improving LLMs' ToM capabilities.

Medical care follows complex clinical pathways that extend beyond isolated physician-patient encounters, emphasizing decision-making and transitions between different stages. Current benchmarks focusing on static exams or isolated dialogues inadequately evaluate large language models (LLMs) in dynamic clinical scenarios. We introduce CP-Env, a controllable agentic hospital environment designed to evaluate LLMs across end-to-end clinical pathways. CP-Env simulates a hospital ecosystem with patient and physician agents, constructing scenarios ranging from triage and specialist consultation to diagnostic testing and multidisciplinary team meetings for agent interaction. Following real hospital adaptive flow of healthcare, it enables branching, long-horizon task execution. We propose a three-tiered evaluation framework encompassing Clinical Efficacy, Process Competency, and Professional Ethics. Results reveal that most models struggle with pathway complexity, exhibiting hallucinations and losing critical diagnostic details. Interestingly, excessive reasoning steps can sometimes prove counterproductive, while top models tend to exhibit reduced tool dependency through internalized knowledge. CP-Env advances medical AI agents development through comprehensive end-to-end clinical evaluation. We provide the benchmark and evaluation tools for further research and development at https://github.com/SPIRAL-MED/CP_ENV.

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.

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.

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) can be used to serve as agents to simulate human behaviors, given the powerful ability to understand human instructions and provide high-quality generated texts. Such ability stimulates us to wonder whether LLMs can simulate a person in a higher form than simple human behaviors. Therefore, we aim to train an agent with the profile, experience, and emotional states of a specific person instead of using limited prompts to instruct ChatGPT API. In this work, we introduce Character-LLM that teach LLMs to act as specific people such as Beethoven, Queen Cleopatra, Julius Caesar, etc. Our method focuses on editing profiles as experiences of a certain character and training models to be personal simulacra with these experiences. To assess the effectiveness of our approach, we build a test playground that interviews trained agents and evaluates whether the agents memorize their characters and experiences. Experimental results show interesting observations that help build future simulacra of humankind.

Understanding human behavior and society is a central focus in social sciences, with the rise of generative social science marking a significant paradigmatic shift. By leveraging bottom-up simulations, it replaces costly and logistically challenging traditional experiments with scalable, replicable, and systematic computational approaches for studying complex social dynamics. Recent advances in large language models (LLMs) have further transformed this research paradigm, enabling the creation of human-like generative social agents and realistic simulacra of society. In this paper, we propose AgentSociety, a large-scale social simulator that integrates LLM-driven agents, a realistic societal environment, and a powerful large-scale simulation engine. Based on the proposed simulator, we generate social lives for over 10k agents, simulating their 5 million interactions both among agents and between agents and their environment. Furthermore, we explore the potential of AgentSociety as a testbed for computational social experiments, focusing on four key social issues: polarization, the spread of inflammatory messages, the effects of universal basic income policies, and the impact of external shocks such as hurricanes. These four issues serve as valuable cases for assessing AgentSociety's support for typical research methods -- such as surveys, interviews, and interventions -- as well as for investigating the patterns, causes, and underlying mechanisms of social issues. The alignment between AgentSociety's outcomes and real-world experimental results not only demonstrates its ability to capture human behaviors and their underlying mechanisms, but also underscores its potential as an important platform for social scientists and policymakers.

Benefiting from the powerful capabilities of large language models (LLMs), agents based on LLMs have shown the potential to address domain-specific tasks and emulate human behaviors. However, the content generated by these agents remains somewhat superficial, owing to their limited domain expertise and the absence of an effective cognitive architecture. To address this, we present the Configurable General Multi-Agent Interaction (CGMI) framework, designed to replicate human interactions in real-world scenarios. Specifically, we propose a tree-structured methodology for the assignment, detection, and maintenance of agent personality. Additionally, we designed a cognitive architecture equipped with a skill library based on the ACT* model, which contains memory, reflection, and planning modules. We have also integrated general agents to augment the virtual environment's realism. Using the CGMI framework, we simulated numerous classroom interactions between teacher and students. The experiments indicate that aspects such as the teaching methodology, curriculum, and student performance closely mirror real classroom settings. We will open source our work.

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

Can small language models with 0.5B to 5B parameters meaningfully engage in trauma-informed, empathetic dialogue for individuals with PTSD? We address this question by introducing TIDE, a dataset of 10,000 two-turn dialogues spanning 500 diverse PTSD client personas and grounded in a three-factor empathy model: emotion recognition, distress normalization, and supportive reflection. All scenarios and reference responses were reviewed for realism and trauma sensitivity by a clinical psychologist specializing in PTSD. We evaluate eight small language models before and after fine-tuning, comparing their outputs to a frontier model (Claude Sonnet 3.5). Our IRB-approved human evaluation and automatic metrics show that fine-tuning generally improves perceived empathy, but gains are highly scenario- and user-dependent, with smaller models facing an empathy ceiling. Demographic analysis shows older adults value distress validation and graduate-educated users prefer nuanced replies, while gender effects are minimal. We highlight the limitations of automatic metrics and the need for context- and user-aware system design. Our findings, along with the planned release of TIDE, provide a foundation for building safe, resource-efficient, and ethically sound empathetic AI to supplement, not replace, clinical mental health care.

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

User simulation is important for developing and evaluating human-centered AI, yet current student simulation in educational applications has significant limitations. Existing approaches focus on single learning experiences and do not account for students' gradual knowledge construction and evolving skill sets. Moreover, large language models are optimized to produce direct and accurate responses, making it challenging to represent the incomplete understanding and developmental constraints that characterize real learners. In this paper, we introduce a novel framework for memory-based student simulation that incorporates developmental trajectories through a hierarchical memory mechanism with structured knowledge representation. The framework also integrates metacognitive processes and personality traits to enrich the individual learner profiling, through dynamical consolidation of both cognitive development and personal learning characteristics. In practice, we implement a curriculum-aligned simulator grounded on the Next Generation Science Standards. Experimental results show that our approach can effectively reflect the gradual nature of knowledge development and the characteristic difficulties students face, providing a more accurate representation of learning processes.

Conversations with LMs involve two participants: a human user leading the conversation, and an LM assistant responding to the user's request. To satisfy this specific role, LMs are post-trained to be helpful assistants -- optimized to produce exhaustive and well-structured responses, free of ambiguity and grammar errors. User utterances, on the other hand, are rarely perfected, with each user phrasing requests in unique ways, sometimes putting in partial effort at each turn and refining on the fly. To evaluate LM performance in realistic settings, prior work simulated users in multi-turn conversations, often prompting an LLM originally trained to be a helpful assistant to act as a user. However, we show that assistant LMs make for poor user simulators, with the surprising finding that better assistants yield worse simulators. Instead, we introduce purpose-built User Language Models (User LMs) - models post-trained to simulate human users in multi-turn conversations. Through various evaluations, we show how User LMs align better with human behavior and achieve better simulation robustness than existing simulation methods. When leveraging User LMs to simulate coding and math conversations, the performance of a strong assistant (GPT-4o) drops from 74.6% to 57.4%, confirming that more realistic simulation environments lead to assistant struggles as they fail to cope with the nuances of users in multi-turn setups.

Background: Emerging reports of "AI psychosis" are on the rise, where user-LLM interactions may exacerbate or induce psychosis or adverse psychological symptoms. Whilst the sycophantic and agreeable nature of LLMs can be beneficial, it becomes a vector for harm by reinforcing delusional beliefs in vulnerable users. Methods: Psychosis-bench is a novel benchmark designed to systematically evaluate the psychogenicity of LLMs comprises 16 structured, 12-turn conversational scenarios simulating the progression of delusional themes(Erotic Delusions, Grandiose/Messianic Delusions, Referential Delusions) and potential harms. We evaluated eight prominent LLMs for Delusion Confirmation (DCS), Harm Enablement (HES), and Safety Intervention(SIS) across explicit and implicit conversational contexts. Findings: Across 1,536 simulated conversation turns, all LLMs demonstrated psychogenic potential, showing a strong tendency to perpetuate rather than challenge delusions (mean DCS of 0.91 pm0.88). Models frequently enabled harmful user requests (mean HES of 0.69 pm0.84) and offered safety interventions in only roughly a third of applicable turns (mean SIS of 0.37 pm0.48). 51 / 128 (39.8%) of scenarios had no safety interventions offered. Performance was significantly worse in implicit scenarios, models were more likely to confirm delusions and enable harm while offering fewer interventions (p < .001). A strong correlation was found between DCS and HES (rs = .77). Model performance varied widely, indicating that safety is not an emergent property of scale alone. Conclusion: This study establishes LLM psychogenicity as a quantifiable risk and underscores the urgent need for re-thinking how we train LLMs. We frame this issue not merely as a technical challenge but as a public health imperative requiring collaboration between developers, policymakers, and healthcare professionals.

Large language models are increasingly used for mental health support, yet their conversational coherence alone does not ensure clinical appropriateness. Existing general-purpose safeguards often fail to distinguish between therapeutic disclosures and genuine clinical crises, leading to safety failures. To address this gap, we introduce a clinically grounded risk taxonomy, developed in collaboration with PhD-level psychologists, that identifies actionable harm (e.g., self-harm and harm to others) while preserving space for safe, non-crisis therapeutic content. We release MindGuard-testset, a dataset of real-world multi-turn conversations annotated at the turn level by clinical experts. Using synthetic dialogues generated via a controlled two-agent setup, we train MindGuard, a family of lightweight safety classifiers (with 4B and 8B parameters). Our classifiers reduce false positives at high-recall operating points and, when paired with clinician language models, help achieve lower attack success and harmful engagement rates in adversarial multi-turn interactions compared to general-purpose safeguards. We release all models and human evaluation data.

This paper introduces DeepPsy-Agent, an innovative psychological support system that combines the three-stage helping theory in psychology with deep learning techniques. The system consists of two core components: (1) a multi-stage response-capable dialogue model (deeppsy-chat), which enhances reasoning capabilities through stage-awareness and deep-thinking analysis to generate high-quality responses; and (2) a real-time stage transition detection model that identifies contextual shifts to guide the dialogue towards more effective intervention stages. Based on 30,000 real psychological hotline conversations, we employ AI-simulated dialogues and expert re-annotation strategies to construct a high-quality multi-turn dialogue dataset. Experimental results demonstrate that DeepPsy-Agent outperforms general-purpose large language models (LLMs) in key metrics such as problem exposure completeness, cognitive restructuring success rate, and action adoption rate. Ablation studies further validate the effectiveness of stage-awareness and deep-thinking modules, showing that stage information contributes 42.3\% to performance, while the deep-thinking module increases root-cause identification by 58.3\% and reduces ineffective suggestions by 72.1\%. This system addresses critical challenges in AI-based psychological support through dynamic dialogue management and deep reasoning, advancing intelligent mental health services.

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.

Language model users often embed personal and social context in their questions. The asker's role -- implicit in how the question is framed -- creates specific needs for an appropriate response. However, most evaluations, while capturing the model's capability to respond, often ignore who is asking. This gap is especially critical in stigmatized domains such as opioid use disorder (OUD), where accounting for users' contexts is essential to provide accessible, stigma-free responses. We propose CoRUS (COmmunity-driven Roles for User-centric Question Simulation), a framework for simulating role-based questions. Drawing on role theory and posts from an online OUD recovery community (r/OpiatesRecovery), we first build a taxonomy of asker roles -- patients, caregivers, practitioners. Next, we use it to simulate 15,321 questions that embed each role's goals, behaviors, and experiences. Our evaluations show that these questions are both highly believable and comparable to real-world data. When used to evaluate five LLMs, for the same question but differing roles, we find systematic differences: vulnerable roles, such as patients and caregivers, elicit more supportive responses (+17%) and reduced knowledge content (-19%) in comparison to practitioners. Our work demonstrates how implicitly signaling a user's role shapes model responses, and provides a methodology for role-informed evaluation of conversational AI.

Persona conditioning can be viewed as a behavioral prior for large language models (LLMs) and is often assumed to confer expertise and improve safety in a monotonic manner. However, its effects on high-stakes clinical decision-making remain poorly characterized. We systematically evaluate persona-based control in clinical LLMs, examining how professional roles (e.g., Emergency Department physician, nurse) and interaction styles (bold vs.\ cautious) influence behavior across models and medical tasks. We assess performance on clinical triage and patient-safety tasks using multidimensional evaluations that capture task accuracy, calibration, and safety-relevant risk behavior. We find systematic, context-dependent, and non-monotonic effects: Medical personas improve performance in critical care tasks, yielding gains of up to sim+20% in accuracy and calibration, but degrade performance in primary-care settings by comparable margins. Interaction style modulates risk propensity and sensitivity, but it's highly model-dependent. While aggregated LLM-judge rankings favor medical over non-medical personas in safety-critical cases, we found that human clinicians show moderate agreement on safety compliance (average Cohen's κ= 0.43) but indicate a low confidence in 95.9\% of their responses on reasoning quality. Our work shows that personas function as behavioral priors that introduce context-dependent trade-offs rather than guarantees of safety or expertise. The code is available at https://github.com/rsinghlab/Persona\_Paradox.

Social network simulation plays a crucial role in addressing various challenges within social science. It offers extensive applications such as state prediction, phenomena explanation, and policy-making support, among others. In this work, we harness the formidable human-like capabilities exhibited by large language models (LLMs) in sensing, reasoning, and behaving, and utilize these qualities to construct the S^3 system (short for Social network Simulation System). Adhering to the widely employed agent-based simulation paradigm, we employ prompt engineering and prompt tuning techniques to ensure that the agent's behavior closely emulates that of a genuine human within the social network. Specifically, we simulate three pivotal aspects: emotion, attitude, and interaction behaviors. By endowing the agent in the system with the ability to perceive the informational environment and emulate human actions, we observe the emergence of population-level phenomena, including the propagation of information, attitudes, and emotions. We conduct an evaluation encompassing two levels of simulation, employing real-world social network data. Encouragingly, the results demonstrate promising accuracy. This work represents an initial step in the realm of social network simulation empowered by LLM-based agents. We anticipate that our endeavors will serve as a source of inspiration for the development of simulation systems within, but not limited to, social science.

LLM role-playing, i.e., using LLMs to simulate specific personas, has emerged as a key capability in various applications, such as companionship, content creation, and digital games. While current models effectively capture character tones and knowledge, simulating the inner thoughts behind their behaviors remains a challenge. Towards cognitive simulation in LLM role-play, previous efforts mainly suffer from two deficiencies: data with high-quality reasoning traces, and reliable reward signals aligned with human preferences. In this paper, we propose HER, a unified framework for cognitive-level persona simulation. HER introduces dual-layer thinking, which distinguishes characters' first-person thinking from LLMs' third-person thinking. To bridge these gaps, we curate reasoning-augmented role-playing data via reverse engineering and construct human-aligned principles and reward models. Leveraging these resources, we train \method models based on Qwen3-32B via supervised and reinforcement learning. Extensive experiments validate the effectiveness of our approach. Notably, our models significantly outperform the Qwen3-32B baseline, achieving a 30.26 improvement on the CoSER benchmark and a 14.97 gain on the Minimax Role-Play Bench. Our datasets, principles, and models will be released to facilitate future research.

Recent advances in Large Language Models (LLM) have led to a new class of autonomous agents, renewing and expanding interest in the area. LLM-powered Multiagent Systems (MAS) have thus emerged, both for assistive and simulation purposes, yet tools for realistic human behavior simulation -- with its distinctive challenges and opportunities -- remain underdeveloped. Existing MAS libraries and tools lack fine-grained persona specifications, population sampling facilities, experimentation support, and integrated validation, among other key capabilities, limiting their utility for behavioral studies, social simulation, and related applications. To address these deficiencies, in this work we introduce TinyTroupe, a simulation toolkit enabling detailed persona definitions (e.g., nationality, age, occupation, personality, beliefs, behaviors) and programmatic control via numerous LLM-driven mechanisms. This allows for the concise formulation of behavioral problems of practical interest, either at the individual or group level, and provides effective means for their solution. TinyTroupe's components are presented using representative working examples, such as brainstorming and market research sessions, thereby simultaneously clarifying their purpose and demonstrating their usefulness. Quantitative and qualitative evaluations of selected aspects are also provided, highlighting possibilities, limitations, and trade-offs. The approach, though realized as a specific Python implementation, is meant as a novel conceptual contribution, which can be partially or fully incorporated in other contexts. The library is available as open source at https://github.com/microsoft/tinytroupe.

Traditional applications of natural language processing (NLP) in healthcare have predominantly focused on patient-centered services, enhancing patient interactions and care delivery, such as through medical dialogue systems. However, the potential of NLP to benefit inexperienced doctors, particularly in areas such as communicative medical coaching, remains largely unexplored. We introduce ``ChatCoach,'' an integrated human-AI cooperative framework. Within this framework, both a patient agent and a coaching agent collaboratively support medical learners in practicing their medical communication skills during consultations. Unlike traditional dialogue systems, ChatCoach provides a simulated environment where a human doctor can engage in medical dialogue with a patient agent. Simultaneously, a coaching agent provides real-time feedback to the doctor. To construct the ChatCoach system, we developed a dataset and integrated Large Language Models such as ChatGPT and Llama2, aiming to assess their effectiveness in communicative medical coaching tasks. Our comparative analysis demonstrates that instruction-tuned Llama2 significantly outperforms ChatGPT's prompting-based approaches.

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.

A World Model is a generative model used to simulate an environment. World Models have proven capable of learning spatial and temporal representations of Reinforcement Learning environments. In some cases, a World Model offers an agent the opportunity to learn entirely inside of its own dream environment. In this work we explore improving the generalization capabilities from dream environments to real environments (Dream2Real). We present a general approach to improve a controller's ability to transfer from a neural network dream environment to reality at little additional cost. These improvements are gained by drawing on inspiration from Domain Randomization, where the basic idea is to randomize as much of a simulator as possible without fundamentally changing the task at hand. Generally, Domain Randomization assumes access to a pre-built simulator with configurable parameters but oftentimes this is not available. By training the World Model using dropout, the dream environment is capable of creating a nearly infinite number of different dream environments. Previous use cases of dropout either do not use dropout at inference time or averages the predictions generated by multiple sampled masks (Monte-Carlo Dropout). Dropout's Dream Land leverages each unique mask to create a diverse set of dream environments. Our experimental results show that Dropout's Dream Land is an effective technique to bridge the reality gap between dream environments and reality. Furthermore, we additionally perform an extensive set of ablation studies.

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.

In online learning environments, students often lack personalized peer interactions, which are crucial for cognitive development and learning engagement. Although previous studies have employed large language models (LLMs) to simulate interactive learning environments, these interactions are limited to conversational exchanges, failing to adapt to learners' individualized cognitive and psychological states. As a result, students' engagement is low and they struggle to gain inspiration. To address this challenge, we propose OnlineMate, a multi-agent learning companion system driven by LLMs integrated with Theory of Mind (ToM). OnlineMate simulates peer-like roles, infers learners' psychological states such as misunderstandings and confusion during collaborative discussions, and dynamically adjusts interaction strategies to support higher-order thinking. Comprehensive evaluations, including simulation-based experiments, human assessments, and real classroom trials, demonstrate that OnlineMate significantly promotes deep learning and cognitive engagement by elevating students' average cognitive level while substantially improving emotional engagement scores.

Diagnosing and managing a patient is a complex, sequential decision making process that requires physicians to obtain information -- such as which tests to perform -- and to act upon it. Recent advances in artificial intelligence (AI) and large language models (LLMs) promise to profoundly impact clinical care. However, current evaluation schemes overrely on static medical question-answering benchmarks, falling short on interactive decision-making that is required in real-life clinical work. Here, we present AgentClinic: a multimodal benchmark to evaluate LLMs in their ability to operate as agents in simulated clinical environments. In our benchmark, the doctor agent must uncover the patient's diagnosis through dialogue and active data collection. We present two open medical agent benchmarks: a multimodal image and dialogue environment, AgentClinic-NEJM, and a dialogue-only environment, AgentClinic-MedQA. We embed cognitive and implicit biases both in patient and doctor agents to emulate realistic interactions between biased agents. We find that introducing bias leads to large reductions in diagnostic accuracy of the doctor agents, as well as reduced compliance, confidence, and follow-up consultation willingness in patient agents. Evaluating a suite of state-of-the-art LLMs, we find that several models that excel in benchmarks like MedQA are performing poorly in AgentClinic-MedQA. We find that the LLM used in the patient agent is an important factor for performance in the AgentClinic benchmark. We show that both having limited interactions as well as too many interaction reduces diagnostic accuracy in doctor agents. The code and data for this work is publicly available at https://AgentClinic.github.io.

Existing methods for simulating individual identities often oversimplify human complexity, which may lead to incomplete or flattened representations. To address this, we introduce SPeCtrum, a grounded framework for constructing authentic LLM agent personas by incorporating an individual's multidimensional self-concept. SPeCtrum integrates three core components: Social Identity (S), Personal Identity (P), and Personal Life Context (C), each contributing distinct yet interconnected aspects of identity. To evaluate SPeCtrum's effectiveness in identity representation, we conducted automated and human evaluations. Automated evaluations using popular drama characters showed that Personal Life Context (C)-derived from short essays on preferences and daily routines-modeled characters' identities more effectively than Social Identity (S) and Personal Identity (P) alone and performed comparably to the full SPC combination. In contrast, human evaluations involving real-world individuals found that the full SPC combination provided a more comprehensive self-concept representation than C alone. Our findings suggest that while C alone may suffice for basic identity simulation, integrating S, P, and C enhances the authenticity and accuracy of real-world identity representation. Overall, SPeCtrum offers a structured approach for simulating individuals in LLM agents, enabling more personalized human-AI interactions and improving the realism of simulation-based behavioral studies.

The final frontier for simulation is the accurate representation of complex, real-world social systems. While agent-based modeling (ABM) seeks to study the behavior and interactions of agents within a larger system, it is unable to faithfully capture the full complexity of human-driven behavior. Large language models (LLMs), like ChatGPT, have emerged as a potential solution to this bottleneck by enabling researchers to explore human-driven interactions in previously unimaginable ways. Our research investigates simulations of human interactions using LLMs. Through prompt engineering, inspired by Park et al. (2023), we present two simulations of believable proxies of human behavior: a two-agent negotiation and a six-agent murder mystery game.

Artificial intelligence has significantly advanced healthcare, particularly through large language models (LLMs) that excel in medical question answering benchmarks. However, their real-world clinical application remains limited due to the complexities of doctor-patient interactions. To address this, we introduce AI Hospital, a multi-agent framework simulating dynamic medical interactions between Doctor as player and NPCs including Patient, Examiner, Chief Physician. This setup allows for realistic assessments of LLMs in clinical scenarios. We develop the Multi-View Medical Evaluation (MVME) benchmark, utilizing high-quality Chinese medical records and NPCs to evaluate LLMs' performance in symptom collection, examination recommendations, and diagnoses. Additionally, a dispute resolution collaborative mechanism is proposed to enhance diagnostic accuracy through iterative discussions. Despite improvements, current LLMs exhibit significant performance gaps in multi-turn interactions compared to one-step approaches. Our findings highlight the need for further research to bridge these gaps and improve LLMs' clinical diagnostic capabilities. Our data, code, and experimental results are all open-sourced at https://github.com/LibertFan/AI_Hospital.

The process of creating training data to teach models is currently driven by humans, who manually analyze model weaknesses and plan how to create data that improves a student model. Recent approaches using LLMs as annotators reduce human effort, but still require humans to interpret feedback from evaluations and control the LLM to produce data the student needs. Automating this labor-intensive process by creating autonomous data generation agents - or teachers - is desirable, but requires environments that can simulate the feedback-driven, iterative, closed loop of data creation. To enable rapid and scalable testing for such agents and their modules, we introduce DataEnvGym, a testbed of teacher environments for data generation agents. DataEnvGym frames data generation as a sequential decision-making task, involving an agent consisting of a data generation policy (which generates a plan for creating training data) and a data generation engine (which transforms the plan into data), inside an environment that provides student feedback. The agent's goal is to improve student performance. Students are iteratively trained and evaluated on generated data, with their feedback (in the form of errors or weak skills) being reported to the agent after each iteration. DataEnvGym includes multiple teacher environment instantiations across 3 levels of structure in the state representation and action space. More structured environments are based on inferred skills and offer more interpretability and curriculum control. We support 3 diverse tasks (math, code, and VQA) and test multiple students and teachers. Example agents in our teaching environments can iteratively improve students across tasks and settings. Moreover, we show that environments teach different skill levels and test variants of key modules, pointing to future work in improving data generation agents, engines, and feedback mechanisms.

While reinforcement learning (RL) can empower large language model (LLM) agents by enabling self-improvement through interaction, its practical adoption remains challenging due to costly rollouts, limited task diversity, unreliable reward signals, and infrastructure complexity, all of which obstruct the collection of scalable experience data. To address these challenges, we introduce DreamGym, the first unified framework designed to synthesize diverse experiences with scalability in mind to enable effective online RL training for autonomous agents. Rather than relying on expensive real-environment rollouts, DreamGym distills environment dynamics into a reasoning-based experience model that derives consistent state transitions and feedback signals through step-by-step reasoning, enabling scalable agent rollout collection for RL. To improve the stability and quality of transitions, DreamGym leverages an experience replay buffer initialized with offline real-world data and continuously enriched with fresh interactions to actively support agent training. To improve knowledge acquisition, DreamGym adaptively generates new tasks that challenge the current agent policy, enabling more effective online curriculum learning. Experiments across diverse environments and agent backbones demonstrate that DreamGym substantially improves RL training, both in fully synthetic settings and in sim-to-real transfer scenarios. On non-RL-ready tasks like WebArena, DreamGym outperforms all baselines by over 30%. And in RL-ready but costly settings, it matches GRPO and PPO performance using only synthetic interactions. When transferring a policy trained purely on synthetic experiences to real-environment RL, DreamGym yields significant additional performance gains while requiring far fewer real-world interactions, providing a scalable warm-start strategy for general-purpose RL.

Role-playing is a crucial capability of Large Language Models (LLMs), enabling a wide range of practical applications, including intelligent non-player characters, digital twins, and emotional companions. Evaluating this capability in LLMs is challenging due to the complex dynamics involved in role-playing, such as maintaining character fidelity throughout a storyline and navigating open-ended narratives without a definitive ground truth. Current evaluation methods, which primarily focus on question-answering or conversational snapshots, fall short of adequately capturing the nuanced character traits and behaviors essential for authentic role-playing. In this paper, we propose CharacterBox, which is a simulation sandbox designed to generate situational fine-grained character behavior trajectories. These behavior trajectories enable a more comprehensive and in-depth evaluation of role-playing capabilities. CharacterBox consists of two main components: the character agent and the narrator agent. The character agent, grounded in psychological and behavioral science, exhibits human-like behaviors, while the narrator agent coordinates interactions between character agents and environmental changes. Additionally, we introduce two trajectory-based methods that leverage CharacterBox to enhance LLM performance. To reduce costs and facilitate the adoption of CharacterBox by public communities, we fine-tune two smaller models, CharacterNR and CharacterRM, as substitutes for GPT API calls, and demonstrate their competitive performance compared to advanced GPT APIs.

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.