Rethinking the Alignment of Psychotherapy Dialogue Generation with Motivational Interviewing Strategies
On the map: LLM reasoning → Clinical and biomedical applications
Abstract (arXiv)
Recent advancements in large language models (LLMs) have shown promise in generating psychotherapeutic dialogues, particularly in the context of motivational interviewing (MI). However, the inherent lack of transparency in LLM outputs presents significant challenges given the sensitive nature of psychotherapy. Applying MI strategies, a set of MI skills, to generate more controllable therapeutic-adherent conversations with explainability provides a possible solution. In this work, we explore the alignment of LLMs with MI strategies by first prompting the LLMs to predict the appropriate strategies as reasoning and then utilizing these strategies to guide the subsequent dialogue generation. We seek to investigate whether such alignment leads to more controllable and explainable generations. Multiple experiments including automatic and human evaluations are conducted to validate the effectiveness of MI strategies in aligning psychotherapy dialogue generation. Our findings demonstrate the potential of LLMs in producing strategically aligned dialogues and suggest directions for practical applications in psychotherapeutic settings.
Key facts. Cited by 9 papers in the map (data through 7 Oct 2026). Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning. Builds on 14 of its 57 references that are in the map. First posted on arXiv 12 Aug 2024.
Builds on
14 of 57 references.
References · 14
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Built on by
Citing papers per year: 2024: 2; 2025: 3; 2026: 4.
9 papers.
- 2025Trustworthy AI Psychotherapy: Multi-Agent LLM Workflow for Counseling and Explainable Mental Disorder Diagnosiscited by 8
- 2024Script-Strategy Aligned Generation: Aligning LLMs with Expert-Crafted Dialogue Scripts and Therapeutic Strategies for Psychotherapycited by 7
- 2026Affective Flow Language Model for Emotional Support Conversationcited by 2
- 2024Therapy as an NLP Task: Comparing LLMs and Human Peers Behaviors in CBT Sessionscited by 0
- 2025When LLM Therapists Become Salespeople: Evaluating Large Language Models for Ethical Motivational Interviewingcited by 0
- 2025MultiJustice: A Chinese Dataset for Multi-Party, Multi-Charge Legal Predictioncited by 0
- 2026StoryMI: Steerable Multi-Agent Therapeutic Dialogue Generationcited by 0
- 2026Expert-Level Crisis Detection in Mental Health Conversationscited by 0
- 2026MIThinker: A Plug-and-Play Policy-Optimized Thinker For Motivational Interviewing Counselingcited by 0
- 2026MIThinker: A Plug-and-Play Policy-Optimized Thinker For Motivational Interviewing Counseling28 Jun 2026
- 2026Expert-Level Crisis Detection in Mental Health Conversations9 Jun 2026
- 2026StoryMI: Steerable Multi-Agent Therapeutic Dialogue Generation18 Apr 2026
- 2026Affective Flow Language Model for Emotional Support Conversation9 Feb 2026
- 2025Trustworthy AI Psychotherapy: Multi-Agent LLM Workflow for Counseling and Explainable Mental Disorder Diagnosis15 Aug 2025
- 2025MultiJustice: A Chinese Dataset for Multi-Party, Multi-Charge Legal Prediction9 Jul 2025
- 2025When LLM Therapists Become Salespeople: Evaluating Large Language Models for Ethical Motivational Interviewing30 Mar 2025
- 2024Script-Strategy Aligned Generation: Aligning LLMs with Expert-Crafted Dialogue Scripts and Therapeutic Strategies for Psychotherapy11 Nov 2024
- 2024Therapy as an NLP Task: Comparing LLMs and Human Peers Behaviors in CBT Sessions3 Sep 2024
Similar, not cited
Close in wording, no citation either way
- 2026CALM-IT: Generating Realistic Long-Form Motivational Interviewing Dialogues with Dual-Actor Conversational Dynamics Tracking
- 2024Unlocking LLMs: Addressing Scarce Data and Bias Challenges in Mental Health
- 2024Domain-Specific Improvement on Psychotherapy Chatbot Using Assistant
- 2026Assessing the Effectiveness of LLMs in Delivering Cognitive Behavioral Therapy
- 2026Steering the Compass: Aligning Dynamic Psychological Counseling Conversations with Cognitive Behavioral Therapy Strategies
- 2025AI-Augmented LLMs Achieve Therapist-Level Responses in Motivational Interviewing
- 2025Evaluating Behavioral Alignment in Conflict Dialogue: A Multi-Dimensional Comparison of LLM Agents and Humans
- 2024Advancing Conversational Psychotherapy: Integrating Privacy, Dual-Memory, and Domain Expertise with Large Language Models