# A Computational Approach to Understanding Empathy Expressed in Text-Based Mental Health Support

arXiv: https://arxiv.org/abs/2009.08441 · HTML: https://mlsanity.com/paper/2009.08441/

## Key facts

- Cited by 182 papers in the map (data through 14 Oct 2026).
- First posted on arXiv 17 Sep 2020.

## Built on by (most cited first, 30 of 182)

- [Towards Emotional Support Dialog Systems](https://mlsanity.com/paper/2106.01144/) (2021)
- [Can Large Language Models Transform Computational Social Science?](https://mlsanity.com/paper/2305.03514/) (2023)
- [Latent Hatred: A Benchmark for Understanding Implicit Hate Speech](https://mlsanity.com/paper/2109.05322/) (2021)
- [PsyQA: A Chinese Dataset for Generating Long Counseling Text for Mental Health Support](https://mlsanity.com/paper/2106.01702/) (2021)
- [Towards Conversational Diagnostic AI](https://mlsanity.com/paper/2401.05654/) (2024)
- [Cognitive Reframing of Negative Thoughts through Human-Language Model Interaction](https://mlsanity.com/paper/2305.02466/) (2023)
- [Towards Facilitating Empathic Conversations in Online Mental Health Support: A Reinforcement Learning Approach](https://mlsanity.com/paper/2101.07714/) (2021)
- [On the Safety of Conversational Models: Taxonomy, Dataset, and Benchmark](https://mlsanity.com/paper/2110.08466/) (2021)
- [Humanoid Agents: Platform for Simulating Human-like Generative Agents](https://mlsanity.com/paper/2310.05418/) (2023)
- [Human-AI Collaboration Enables More Empathic Conversations in Text-based Peer-to-Peer Mental Health Support](https://mlsanity.com/paper/2203.15144/) (2022)
- [Do LLMs Understand Social Knowledge? Evaluating the Sociability of Large Language Models with SocKET Benchmark](https://mlsanity.com/paper/2305.14938/) (2023)
- [Cue-CoT: Chain-of-thought Prompting for Responding to In-depth Dialogue Questions with LLMs](https://mlsanity.com/paper/2305.11792/) (2023)
- [Building Emotional Support Chatbots in the Era of LLMs](https://mlsanity.com/paper/2308.11584/) (2023)
- [Improving Multi-turn Emotional Support Dialogue Generation with Lookahead Strategy Planning](https://mlsanity.com/paper/2210.04242/) (2022)
- [Beyond Fair Pay: Ethical Implications of NLP Crowdsourcing](https://mlsanity.com/paper/2104.10097/) (2021)
- [Facilitating Self-Guided Mental Health Interventions Through Human-Language Model Interaction: A Case Study of Cognitive Restructuring](https://mlsanity.com/paper/2310.15461/) (2023)
- [ESCoT: Towards Interpretable Emotional Support Dialogue Systems](https://mlsanity.com/paper/2406.10960/) (2024)
- [Perspective-taking and Pragmatics for Generating Empathetic Responses Focused on Emotion Causes](https://mlsanity.com/paper/2109.08828/) (2021)
- [CoMAE: A Multi-factor Hierarchical Framework for Empathetic Response Generation](https://mlsanity.com/paper/2105.08316/) (2021)
- [Harnessing the Power of Large Language Models for Empathetic Response Generation: Empirical Investigations and Improvements](https://mlsanity.com/paper/2310.05140/) (2023)
- [Using Imperfect Surrogates for Downstream Inference: Design-based Supervised Learning for Social Science Applications of Large Language Models](https://mlsanity.com/paper/2306.04746/) (2023)
- [Large Language Models Produce Responses Perceived to be Empathic](https://mlsanity.com/paper/2403.18148/) (2024)
- [Large Language Models in Mental Health Care: a Scoping Review](https://mlsanity.com/paper/2401.02984/) (2024)
- [Empowering Psychotherapy with Large Language Models: Cognitive Distortion Detection through Diagnosis of Thought Prompting](https://mlsanity.com/paper/2310.07146/) (2023)
- [PsychoGAT: A Novel Psychological Measurement Paradigm through Interactive Fiction Games with LLM Agents](https://mlsanity.com/paper/2402.12326/) (2024)
- [RLVER: Reinforcement Learning with Verifiable Emotion Rewards for Empathetic Agents](https://mlsanity.com/paper/2507.03112/) (2025)
- [Chain of Empathy: Enhancing Empathetic Response of Large Language Models Based on Psychotherapy Models](https://mlsanity.com/paper/2311.04915/) (2023)
- [SweetieChat: A Strategy-Enhanced Role-playing Framework for Diverse Scenarios Handling Emotional Support Agent](https://mlsanity.com/paper/2412.08389/) (2024)
- [From Personas to Talks: Revisiting the Impact of Personas on LLM-Synthesized Emotional Support Conversations](https://mlsanity.com/paper/2502.11451/) (2025)
- [Rationalization for Explainable NLP: A Survey](https://mlsanity.com/paper/2301.08912/) (2023)

## Abstract (arXiv)

Empathy is critical to successful mental health support. Empathy measurement has predominantly occurred in synchronous, face-to-face settings, and may not translate to asynchronous, text-based contexts. Because millions of people use text-based platforms for mental health support, understanding empathy in these contexts is crucial. In this work, we present a computational approach to understanding how empathy is expressed in online mental health platforms. We develop a novel unifying theoretically-grounded framework for characterizing the communication of empathy in text-based conversations. We collect and share a corpus of 10k (post, response) pairs annotated using this empathy framework with supporting evidence for annotations (rationales). We develop a multi-task RoBERTa-based bi-encoder model for identifying empathy in conversations and extracting rationales underlying its predictions. Experiments demonstrate that our approach can effectively identify empathic conversations. We further apply this model to analyze 235k mental health interactions and show that users do not self-learn empathy over time, revealing opportunities for empathy training and feedback.