# Cognitive Reframing of Negative Thoughts through Human-Language Model Interaction

arXiv: https://arxiv.org/abs/2305.02466 · HTML: https://mlsanity.com/paper/2305.02466/

## Key facts

- Cited by 77 papers in the map (data through 14 Oct 2026).
- Builds on 26 of its 76 references that are in the map.
- First posted on arXiv 4 May 2023.

## Builds on (most cited first, 26 of 26)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [The Curious Case of Neural Text Degeneration](https://mlsanity.com/paper/1904.09751/) (2019)
- [What Makes Good In-Context Examples for GPT-3?](https://mlsanity.com/paper/2101.06804/) (2021)
- [DialoGPT: Large-Scale Generative Pre-training for Conversational Response Generation](https://mlsanity.com/paper/1911.00536/) (2019)
- [TweetEval: Unified Benchmark and Comparative Evaluation for Tweet Classification](https://mlsanity.com/paper/2010.12421/) (2020)
- [Abductive Commonsense Reasoning](https://mlsanity.com/paper/1908.05739/) (2019)
- [WANLI: Worker and AI Collaboration for Natural Language Inference Dataset Creation](https://mlsanity.com/paper/2201.05955/) (2022)
- [A Computational Approach to Understanding Empathy Expressed in Text-Based Mental Health Support](https://mlsanity.com/paper/2009.08441/) (2020)
- [Maieutic Prompting: Logically Consistent Reasoning with Recursive Explanations](https://mlsanity.com/paper/2205.11822/) (2022)
- [A Recipe For Arbitrary Text Style Transfer with Large Language Models](https://mlsanity.com/paper/2109.03910/) (2021)
- [Politeness Transfer: A Tag and Generate Approach](https://mlsanity.com/paper/2004.14257/) (2020)
- [Towards Facilitating Empathic Conversations in Online Mental Health Support: A Reinforcement Learning Approach](https://mlsanity.com/paper/2101.07714/) (2021)
- [Human-AI Collaboration Enables More Empathic Conversations in Text-based Peer-to-Peer Mental Health Support](https://mlsanity.com/paper/2203.15144/) (2022)
- [Inducing Positive Perspectives with Text Reframing](https://mlsanity.com/paper/2204.02952/) (2022)
- [Better Conversations by Modeling,Filtering,and Optimizing for Coherence and Diversity](https://mlsanity.com/paper/1809.06873/) (2018)
- [Modeling Motivational Interviewing Strategies On An Online Peer-to-Peer Counseling Platform](https://mlsanity.com/paper/2211.05182/) (2022)
- [Balancing Objectives in Counseling Conversations: Advancing Forwards or Looking Backwards](https://mlsanity.com/paper/2005.04245/) (2020)
- [Gendered Mental Health Stigma in Masked Language Models](https://mlsanity.com/paper/2210.15144/) (2022)
- [Engagement Patterns of Peer-to-Peer Interactions on Mental Health Platforms](https://mlsanity.com/paper/2004.04999/) (2020)
- [The Effect of Moderation on Online Mental Health Conversations](https://mlsanity.com/paper/2005.09225/) (2020)
- [Expressive Interviewing: A Conversational System for Coping with COVID-19](https://mlsanity.com/paper/2007.03819/) (2020)
- [Exploring Self-Identified Counseling Expertise in Online Support Forums](https://mlsanity.com/paper/2106.12976/) (2021)
- [Finding Your Voice: The Linguistic Development of Mental Health Counselors](https://mlsanity.com/paper/1906.07194/) (2019)

## Built on by (most cited first, 30 of 77)

- [A Roadmap to Pluralistic Alignment](https://mlsanity.com/paper/2402.05070/) (2024)
- [A Computational Framework for Behavioral Assessment of LLM Therapists](https://mlsanity.com/paper/2401.00820/) (2024)
- [Cactus: Towards Psychological Counseling Conversations using Cognitive Behavioral Theory](https://mlsanity.com/paper/2407.03103/) (2024)
- [Facilitating Self-Guided Mental Health Interventions Through Human-Language Model Interaction: A Case Study of Cognitive Restructuring](https://mlsanity.com/paper/2310.15461/) (2023)
- [Bridging the Novice-Expert Gap via Models of Decision-Making: A Case Study on Remediating Math Mistakes](https://mlsanity.com/paper/2310.10648/) (2023)
- [HealMe: Harnessing Cognitive Reframing in Large Language Models for Psychotherapy](https://mlsanity.com/paper/2403.05574/) (2024)
- [CBT-LLM: A Chinese Large Language Model for Cognitive Behavioral Therapy-based Mental Health Question Answering](https://mlsanity.com/paper/2403.16008/) (2024)
- [Benefits and Harms of Large Language Models in Digital Mental Health](https://mlsanity.com/paper/2311.14693/) (2023)
- [Large Language Models Produce Responses Perceived to be Empathic](https://mlsanity.com/paper/2403.18148/) (2024)
- [PsychoGAT: A Novel Psychological Measurement Paradigm through Interactive Fiction Games with LLM Agents](https://mlsanity.com/paper/2402.12326/) (2024)
- [Mechanistic Interpretability of Emotion Inference in Large Language Models](https://mlsanity.com/paper/2502.05489/) (2025)
- [Can AI Relate: Testing Large Language Model Response for Mental Health Support](https://mlsanity.com/paper/2405.12021/) (2024)
- [PATIENT-Psi: Using Large Language Models to Simulate Patients for Training Mental Health Professionals](https://mlsanity.com/paper/2405.19660/) (2024)
- [Transforming Wearable Data into Personal Health Insights using Large Language Model Agents](https://mlsanity.com/paper/2406.06464/) (2024)
- [Position: Towards Bidirectional Human-AI Alignment](https://mlsanity.com/paper/2406.09264/) (2024)
- [Lived Experience Not Found: LLMs Struggle to Align with Experts on Addressing Adverse Drug Reactions from Psychiatric Medication Use](https://mlsanity.com/paper/2410.19155/) (2024)
- [MAGI: Multi-Agent Guided Interview for Psychiatric Assessment](https://mlsanity.com/paper/2504.18260/) (2025)
- [Large Language Models are Capable of Offering Cognitive Reappraisal, if Guided](https://mlsanity.com/paper/2404.01288/) (2024)
- [The Call for Socially Aware Language Technologies](https://mlsanity.com/paper/2405.02411/) (2024)
- [MIRROR: Multimodal Cognitive Reframing Therapy for Rolling with Resistance](https://mlsanity.com/paper/2504.13211/) (2025)
- [Exploring User Security and Privacy Attitudes and Concerns Toward the Use of General-Purpose LLM Chatbots for Mental Health](https://mlsanity.com/paper/2507.10695/) (2025)
- [IMBUE: Improving Interpersonal Effectiveness through Simulation and Just-in-time Feedback with Human-Language Model Interaction](https://mlsanity.com/paper/2402.12556/) (2024)
- [CBT-Bench: Evaluating Large Language Models on Assisting Cognitive Behavior Therapy](https://mlsanity.com/paper/2410.13218/) (2024)
- [A Survey of Large Language Models in Psychotherapy: Current Landscape and Future Directions](https://mlsanity.com/paper/2502.11095/) (2025)
- [AI on My Shoulder: Supporting Emotional Labor in Front-Office Roles with an LLM-based Empathetic Coworker](https://mlsanity.com/paper/2411.02408/) (2024)
- [Crisp: Cognitive Restructuring of Negative Thoughts through Multi-turn Supportive Dialogues](https://mlsanity.com/paper/2504.17238/) (2025)
- [Feel the Difference? A Comparative Analysis of Emotional Arcs in Real and LLM-Generated CBT Sessions](https://mlsanity.com/paper/2508.20764/) (2025)
- [Encourage or Inhibit Monosemanticity? Revisit Monosemanticity from a Feature Decorrelation Perspective](https://mlsanity.com/paper/2406.17969/) (2024)
- [Supervised Learning and Large Language Model Benchmarks on Mental Health Datasets: Cognitive Distortions and Suicidal Risks in Chinese Social Media](https://mlsanity.com/paper/2309.03564/) (2023)
- [MentalAgora: A Gateway to Advanced Personalized Care in Mental Health through Multi-Agent Debating and Attribute Control](https://mlsanity.com/paper/2407.02736/) (2024)

## Abstract (arXiv)

A proven therapeutic technique to overcome negative thoughts is to replace them with a more hopeful "reframed thought." Although therapy can help people practice and learn this Cognitive Reframing of Negative Thoughts, clinician shortages and mental health stigma commonly limit people's access to therapy. In this paper, we conduct a human-centered study of how language models may assist people in reframing negative thoughts. Based on psychology literature, we define a framework of seven linguistic attributes that can be used to reframe a thought. We develop automated metrics to measure these attributes and validate them with expert judgements from mental health practitioners. We collect a dataset of 600 situations, thoughts and reframes from practitioners and use it to train a retrieval-enhanced in-context learning model that effectively generates reframed thoughts and controls their linguistic attributes. To investigate what constitutes a "high-quality" reframe, we conduct an IRB-approved randomized field study on a large mental health website with over 2,000 participants. Amongst other findings, we show that people prefer highly empathic or specific reframes, as opposed to reframes that are overly positive. Our findings provide key implications for the use of LMs to assist people in overcoming negative thoughts.