mlsanityData to 14 Oct 2026

Chain of Empathy: Enhancing Empathetic Response of Large Language Models Based on Psychotherapy Models

arXiv 2311.04915 ↗First posted 2 Nov 2023cs.CL cs.AI cs.HCcited by 24

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Abstract (arXiv)

We present a novel method, the Chain of Empathy (CoE) prompting, that utilizes insights from psychotherapy to induce Large Language Models (LLMs) to reason about human emotional states. This method is inspired by various psychotherapy approaches including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Person Centered Therapy (PCT), and Reality Therapy (RT), each leading to different patterns of interpreting clients' mental states. LLMs without reasoning generated predominantly exploratory responses. However, when LLMs used CoE reasoning, we found a more comprehensive range of empathetic responses aligned with the different reasoning patterns of each psychotherapy model. The CBT based CoE resulted in the most balanced generation of empathetic responses. The findings underscore the importance of understanding the emotional context and how it affects human and AI communication. Our research contributes to understanding how psychotherapeutic models can be incorporated into LLMs, facilitating the development of context-specific, safer, and empathetic AI.

Key facts. Cited by 24 papers in the map (data through 14 Oct 2026). Builds on 13 of its 39 references that are in the map. First posted on arXiv 2 Nov 2023.

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13 of 39 references.

References · 13

  1. 2020Language Models are Few-Shot Learnerscited by 32,419
  2. 2023LLaMA: Open and Efficient Foundation Language Modelscited by 14,132
  3. 2022Chain-of-Thought Prompting Elicits Reasoning in Large Language Modelscited by 12,459
  4. 2022Large Language Models are Zero-Shot Reasonerscited by 4,374
  5. 2021On the Opportunities and Risks of Foundation Modelscited by 4,033
  6. 2023Tree of Thoughts: Deliberate Problem Solving with Large Language Modelscited by 3,211
  7. 2023Capabilities of GPT-4 on Medical Challenge Problemscited by 638
  8. 2020A Computational Approach to Understanding Empathy Expressed in Text-Based Mental Health Supportcited by 182
  9. 2022GPT Takes the Bar Examcited by 65
  10. 2018Modeling Empathy and Distress in Reaction to News Storiescited by 52
  11. 2023An Empirical Evaluation of Prompting Strategies for Large Language Models in Zero-Shot Clinical Natural Language Processingcited by 19
  12. 2022Psychologically-informed chain-of-thought prompts for metaphor understanding in large language modelscited by 14
1 more
  1. 2022Digital Therapeutics for Mental Health: Is Attrition the Achilles Heel?cited by 1

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Cited by year (2026 to 14 Oct)

Citing papers per year: 2023: 1; 2024: 9; 2025: 10; 2026: 4.

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  1. 2024From Persona to Personalization: A Survey on Role-Playing Language Agentscited by 212
  2. 2024Beyond Chain-of-Thought: A Survey of Chain-of-X Paradigms for LLMscited by 48
  3. 2024Large Language Models in Mental Health Care: a Scoping Reviewcited by 34
  4. 2024Affective Computing in the Era of Large Language Models: A Survey from the NLP Perspectivecited by 25
  5. 2024ERD: A Framework for Improving LLM Reasoning for Cognitive Distortion Classificationcited by 14
  6. 2026HEART: A Unified Benchmark for Assessing Humans and LLMs in Emotional Support Dialoguecited by 13
  7. 2025AI with Emotions: Exploring Emotional Expressions in Large Language Modelscited by 11
  8. 2025OpenS2S: Advancing Fully Open-Source End-to-End Empathetic Large Speech Language Modelcited by 9
  9. 2023Rational Sensibility: LLM Enhanced Empathetic Response Generation Guided by Self-presentation Theorycited by 7
  10. 2025SYNTHEMPATHY: A Scalable Empathy Corpus Generated Using LLMs Without Any Crowdsourcingcited by 7
  11. 2025The Pursuit of Empathy: Evaluating Small Language Models for PTSD Dialogue Supportcited by 6
  12. 2024"I Like Sunnie More Than I Expected!": Exploring User Expectation and Perception of an Anthropomorphic LLM-based Conversational Agent for Well-Being Supportcited by 5
12 more
  1. 2024Integrating Physiological Data with Large Language Models for Empathic Human-AI Interactioncited by 3
  2. 2025RECAP: Transparent Inference-Time Emotion Alignment for Medical Dialogue Systemscited by 3
  3. 2024A Generic Review of Integrating Artificial Intelligence in Cognitive Behavioral Therapycited by 2
  4. 2024Mixed Chain-of-Psychotherapies for Emotional Support Chatbotcited by 2
  5. 2025Somatic in the East, Psychological in the West?: Investigating Clinically-Grounded Cross-Cultural Depression Symptom Expression in LLMscited by 2
  6. 2025Empathy-R1: A Chain-of-Empathy and Reinforcement Learning Framework for Long-Form Mental Health Supportcited by 2
  7. 2025From Measurement to Expertise: Empathetic Expert Adapters for Context-Based Empathy in Conversational AI Agentscited by 1
  8. 2025Bridging Cognition and Emotion: Empathy-Driven Multimodal Misinformation Detectioncited by 0
  9. 2025Why We Need a New Framework for Emotional Intelligence in AIcited by 0
  10. 2026EmoLLM: Appraisal-Grounded Cognitive-Emotional Co-Reasoning in Large Language Modelscited by 0
  11. 2026Mental Health Disorder Detection Beyond Social Media: A Systematic Review of Available Datasetscited by 0
  12. 2026Towards High-Level Semantic Intelligencecited by 0

Similar, not cited

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  1. 2024WundtGPT: Shaping Large Language Models To Be An Empathetic, Proactive Psychologist
  2. 2026Assessing the Effectiveness of LLMs in Delivering Cognitive Behavioral Therapy
  3. 2025Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling
  4. 2024Cause-Aware Empathetic Response Generation via Chain-of-Thought Fine-Tuning
  5. 2026Guiding Language Models to Be More Empathetic: Culturally Sensitive Mental Health Advice Generation Through Human-LLM Collaboration
  6. 2023SoulChat: Improving LLMs' Empathy, Listening, and Comfort Abilities through Fine-tuning with Multi-turn Empathy Conversations
  7. 2025The Thinking Therapist: Training Large Language Models to Deliver Acceptance and Commitment Therapy using Supervised Fine-Tuning and Odds Ratio Policy Optimization
  8. 2026Where do LLMs Fall Short in CBT-Guided Affective Reasoning?