# Facilitating Self-Guided Mental Health Interventions Through Human-Language Model Interaction: A Case Study of Cognitive Restructuring

arXiv: https://arxiv.org/abs/2310.15461 · HTML: https://mlsanity.com/paper/2310.15461/

## Key facts

- Cited by 53 papers in the map (data through 14 Oct 2026).
- Builds on 16 of its 98 references that are in the map.
- First posted on arXiv 24 Oct 2023.

## Builds on (most cited first, 16 of 16)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [The Curious Case of Neural Text Degeneration](https://mlsanity.com/paper/1904.09751/) (2019)
- [A Survey on Bias and Fairness in Machine Learning](https://mlsanity.com/paper/1908.09635/) (2019)
- [Language (Technology) is Power: A Critical Survey of "Bias" in NLP](https://mlsanity.com/paper/2005.14050/) (2020)
- [Semantics derived automatically from language corpora contain human-like biases](https://mlsanity.com/paper/1608.07187/) (2016)
- [A Computational Approach to Understanding Empathy Expressed in Text-Based Mental Health Support](https://mlsanity.com/paper/2009.08441/) (2020)
- [Evaluating Human-Language Model Interaction](https://mlsanity.com/paper/2212.09746/) (2022)
- [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)
- [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)
- [Modeling Motivational Interviewing Strategies On An Online Peer-to-Peer Counseling Platform](https://mlsanity.com/paper/2211.05182/) (2022)
- [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)
- [Response-act Guided Reinforced Dialogue Generation for Mental Health Counseling](https://mlsanity.com/paper/2301.12729/) (2023)

## Built on by (most cited first, 30 of 53)

- [A Roadmap to Pluralistic Alignment](https://mlsanity.com/paper/2402.05070/) (2024)
- [Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providers](https://mlsanity.com/paper/2504.18412/) (2025)
- [A Computational Framework for Behavioral Assessment of LLM Therapists](https://mlsanity.com/paper/2401.00820/) (2024)
- [SynthesizeMe! Inducing Persona-Guided Prompts for Personalized Reward Models in LLMs](https://mlsanity.com/paper/2506.05598/) (2025)
- [Towards a Personal Health Large Language Model](https://mlsanity.com/paper/2406.06474/) (2024)
- [The Typing Cure: Experiences with Large Language Model Chatbots for Mental Health Support](https://mlsanity.com/paper/2401.14362/) (2024)
- [MindScape Study: Integrating LLM and Behavioral Sensing for Personalized AI-Driven Journaling Experiences](https://mlsanity.com/paper/2409.09570/) (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)
- [Understanding the LLM-ification of CHI: Unpacking the Impact of LLMs at CHI through a Systematic Literature Review](https://mlsanity.com/paper/2501.12557/) (2025)
- [Contextual AI Journaling: Integrating LLM and Time Series Behavioral Sensing Technology to Promote Self-Reflection and Well-being using the MindScape App](https://mlsanity.com/paper/2404.00487/) (2024)
- [AI Chatbots for Mental Health: Values and Harms from Lived Experiences of Depression](https://mlsanity.com/paper/2504.18932/) (2025)
- [Mapping Caregiver Needs to AI Chatbot Design: Strengths and Gaps in Mental Health Support for Alzheimer's and Dementia Caregivers](https://mlsanity.com/paper/2506.15047/) (2025)
- [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)
- [Preference Learning Unlocks LLMs' Psycho-Counseling Skills](https://mlsanity.com/paper/2502.19731/) (2025)
- [Mental Health Impacts of AI Companions: Triangulating Social Media Quasi-Experiments, User Perspectives, and Relational Theory](https://mlsanity.com/paper/2509.22505/) (2025)
- [Computational Hermeneutics: Evaluating generative AI as a cultural technology](https://mlsanity.com/paper/2604.16403/) (2026)
- [Balancing Caregiving and Self-Care: Exploring Mental Health Needs of Alzheimer's and Dementia Caregivers](https://mlsanity.com/paper/2506.14196/) (2025)
- [PAIR-SAFE: A Paired-Agent Approach for Runtime Auditing and Refining AI-Mediated Mental Health Support](https://mlsanity.com/paper/2601.12754/) (2026)
- [Detection and Positive Reconstruction of Cognitive Distortion sentences: Mandarin Dataset and Evaluation](https://mlsanity.com/paper/2405.15334/) (2024)
- [Applying and Evaluating Large Language Models in Mental Health Care: A Scoping Review of Human-Assessed Generative Tasks](https://mlsanity.com/paper/2408.11288/) (2024)
- [Understanding Communication Preferences of Information Workers in Engagement with Text-Based Conversational Agents](https://mlsanity.com/paper/2410.20468/) (2024)
- [Substance over Style: Evaluating Proactive Conversational Coaching Agents](https://mlsanity.com/paper/2503.19328/) (2025)
- [Linguistic Comparison of AI- and Human-Written Responses to Online Mental Health Queries](https://mlsanity.com/paper/2504.09271/) (2025)
- [ExploreSelf: Fostering User-driven Exploration and Reflection on Personal Challenges with Adaptive Guidance by Large Language Models](https://mlsanity.com/paper/2409.09662/) (2024)
- [Interpersonal Theory of Suicide as a Lens to Examine Suicidal Ideation in Online Spaces](https://mlsanity.com/paper/2504.13277/) (2025)
- [Building Benchmarks from the Ground Up: Community-Centered Evaluation of LLMs in Healthcare Chatbot Settings](https://mlsanity.com/paper/2509.24506/) (2025)
- [Large Language Model Agents for Improving Engagement with Behavior Change Interventions: Application to Digital Mindfulness](https://mlsanity.com/paper/2407.13067/) (2024)
- [The Interaction Layer: An Exploration for Co-Designing User-LLM Interactions in Parental Wellbeing Support Systems](https://mlsanity.com/paper/2411.01228/) (2024)

## Abstract (arXiv)

Self-guided mental health interventions, such as "do-it-yourself" tools to learn and practice coping strategies, show great promise to improve access to mental health care. However, these interventions are often cognitively demanding and emotionally triggering, creating accessibility barriers that limit their wide-scale implementation and adoption. In this paper, we study how human-language model interaction can support self-guided mental health interventions. We take cognitive restructuring, an evidence-based therapeutic technique to overcome negative thinking, as a case study. In an IRB-approved randomized field study on a large mental health website with 15,531 participants, we design and evaluate a system that uses language models to support people through various steps of cognitive restructuring. Our findings reveal that our system positively impacts emotional intensity for 67% of participants and helps 65% overcome negative thoughts. Although adolescents report relatively worse outcomes, we find that tailored interventions that simplify language model generations improve overall effectiveness and equity.