# Roleplay-doh: Enabling Domain-Experts to Create LLM-simulated Patients via Eliciting and Adhering to Principles

arXiv: https://arxiv.org/abs/2407.00870 · HTML: https://mlsanity.com/paper/2407.00870/

## Key facts

- Cited by 73 papers in the map (data through 14 Oct 2026).
- Builds on 17 of its 70 references that are in the map.
- First posted on arXiv 1 Jul 2024.

## Builds on (most cited first, 17 of 17)

- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [Deep reinforcement learning from human preferences](https://mlsanity.com/paper/1706.03741/) (2017)
- [Generative Agents: Interactive Simulacra of Human Behavior](https://mlsanity.com/paper/2304.03442/) (2023)
- [Self-Refine: Iterative Refinement with Self-Feedback](https://mlsanity.com/paper/2303.17651/) (2023)
- [Constitutional AI: Harmlessness from AI Feedback](https://mlsanity.com/paper/2212.08073/) (2022)
- [Sparks of Artificial General Intelligence: Early experiments with GPT-4](https://mlsanity.com/paper/2303.12712/) (2023)
- [Social Simulacra: Creating Populated Prototypes for Social Computing Systems](https://mlsanity.com/paper/2208.04024/) (2022)
- [Towards Emotional Support Dialog Systems](https://mlsanity.com/paper/2106.01144/) (2021)
- [Branch-Solve-Merge Improves Large Language Model Evaluation and Generation](https://mlsanity.com/paper/2310.15123/) (2023)
- [CoMPosT: Characterizing and Evaluating Caricature in LLM Simulations](https://mlsanity.com/paper/2310.11501/) (2023)
- [EvalLM: Interactive Evaluation of Large Language Model Prompts on User-Defined Criteria](https://mlsanity.com/paper/2309.13633/) (2023)
- [COLLIE: Systematic Construction of Constrained Text Generation Tasks](https://mlsanity.com/paper/2307.08689/) (2023)
- [Is this the real life? Is this just fantasy? The Misleading Success of Simulating Social Interactions With LLMs](https://mlsanity.com/paper/2403.05020/) (2024)
- [ConstitutionMaker: Interactively Critiquing Large Language Models by Converting Feedback into Principles](https://mlsanity.com/paper/2310.15428/) (2023)
- [When Life Gives You Lemons, Make Cherryade: Converting Feedback from Bad Responses into Good Labels](https://mlsanity.com/paper/2210.15893/) (2022)
- [Goldilocks: Consistent Crowdsourced Scalar Annotations with Relative Uncertainty](https://mlsanity.com/paper/2108.01799/) (2021)
- [Seeing Seeds Beyond Weeds: Green Teaming Generative AI for Beneficial Uses](https://mlsanity.com/paper/2306.03097/) (2023)

## Built on by (most cited first, 30 of 73)

- [Programming Refusal with Conditional Activation Steering](https://mlsanity.com/paper/2409.05907/) (2024)
- [PersonaGym: Evaluating Persona Agents and LLMs](https://mlsanity.com/paper/2407.18416/) (2024)
- [Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providers](https://mlsanity.com/paper/2504.18412/) (2025)
- [PatientSim: A Persona-Driven Simulator for Realistic Doctor-Patient Interactions](https://mlsanity.com/paper/2505.17818/) (2025)
- ['Simulacrum of Stories': Examining Large Language Models as Qualitative Research Participants](https://mlsanity.com/paper/2409.19430/) (2024)
- [Multi-turn Evaluation of Anthropomorphic Behaviours in Large Language Models](https://mlsanity.com/paper/2502.07077/) (2025)
- [What Should We Engineer in Prompts? Training Humans in Requirement-Driven LLM Use](https://mlsanity.com/paper/2409.08775/) (2024)
- [LLMs Can Simulate Standardized Patients via Agent Coevolution](https://mlsanity.com/paper/2412.11716/) (2024)
- [EmoAgent: Assessing and Safeguarding Human-AI Interaction for Mental Health Safety](https://mlsanity.com/paper/2504.09689/) (2025)
- [Sentient Agent as a Judge: Evaluating Higher-Order Social Cognition in Large Language Models](https://mlsanity.com/paper/2505.02847/) (2025)
- [Cultural Learning-Based Culture Adaptation of Language Models](https://mlsanity.com/paper/2504.02953/) (2025)
- [PRINCIPLES: Synthetic Strategy Memory for Proactive Dialogue Agents](https://mlsanity.com/paper/2509.17459/) (2025)
- [Scaffolding Empathy: Training Counselors with Simulated Patients and Utterance-level Performance Visualizations](https://mlsanity.com/paper/2502.18673/) (2025)
- [Simulated patient systems powered by large language model-based AI agents offer potential for transforming medical education](https://mlsanity.com/paper/2409.18924/) (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)
- [Fairness Testing of Large Language Models in Role-Playing](https://mlsanity.com/paper/2411.00585/) (2024)
- [Crisp: Cognitive Restructuring of Negative Thoughts through Multi-turn Supportive Dialogues](https://mlsanity.com/paper/2504.17238/) (2025)
- [PingPong: A Benchmark for Role-Playing Language Models with User Emulation and Multi-Model Evaluation](https://mlsanity.com/paper/2409.06820/) (2024)
- [Adaptive-VP: A Framework for LLM-Based Virtual Patients that Adapts to Trainees' Dialogue to Facilitate Nurse Communication Training](https://mlsanity.com/paper/2506.00386/) (2025)
- [The Chameleon's Limit: Investigating Persona Collapse and Homogenization in Large Language Models](https://mlsanity.com/paper/2604.24698/) (2026)
- [Modeling Challenging Patient Interactions: LLMs for Medical Communication Training](https://mlsanity.com/paper/2503.22250/) (2025)
- [PersLLM: A Personified Training Approach for Large Language Models](https://mlsanity.com/paper/2407.12393/) (2024)
- [HamRaz: A Culture-Based Persian Conversation Dataset for Person-Centered Therapy Using LLM Agents](https://mlsanity.com/paper/2502.05982/) (2025)
- [Do Role-Playing Agents Practice What They Preach? Belief-Behavior Consistency in LLM-Based Simulations of Human Trust](https://mlsanity.com/paper/2507.02197/) (2025)
- [TalkDep: Clinically Grounded LLM Personas for Conversation-Centric Depression Screening](https://mlsanity.com/paper/2508.04248/) (2025)
- [Harmful Traits of AI Companions](https://mlsanity.com/paper/2511.14972/) (2025)
- [ChatThero: An LLM-Supported Chatbot for Behavior Change and Therapeutic Support in Addiction Recovery](https://mlsanity.com/paper/2508.20996/) (2025)
- [PatientHub: A Unified Framework for Patient Simulation](https://mlsanity.com/paper/2602.11684/) (2026)
- [CueTip: An Interactive and Explainable Physics-aware Pool Assistant](https://mlsanity.com/paper/2501.18291/) (2025)

## Abstract (arXiv)

Recent works leverage LLMs to roleplay realistic social scenarios, aiding novices in practicing their social skills. However, simulating sensitive interactions, such as in mental health, is challenging. Privacy concerns restrict data access, and collecting expert feedback, although vital, is laborious. To address this, we develop Roleplay-doh, a novel human-LLM collaboration pipeline that elicits qualitative feedback from a domain-expert, which is transformed into a set of principles, or natural language rules, that govern an LLM-prompted roleplay. We apply this pipeline to enable senior mental health supporters to create customized AI patients for simulated practice partners for novice counselors. After uncovering issues in GPT-4 simulations not adhering to expert-defined principles, we also introduce a novel principle-adherence prompting pipeline which shows 30% improvements in response quality and principle following for the downstream task. Via a user study with 25 counseling experts, we demonstrate that the pipeline makes it easy and effective to create AI patients that more faithfully resemble real patients, as judged by creators and third-party counselors. See our project website at https://roleplay-doh.github.io/ for code and data.