CBT-Bench: Evaluating Large Language Models on Assisting Cognitive Behavior Therapy
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Abstract (arXiv)
There is a significant gap between patient needs and available mental health support today. In this paper, we aim to thoroughly examine the potential of using Large Language Models (LLMs) to assist professional psychotherapy. To this end, we propose a new benchmark, CBT-BENCH, for the systematic evaluation of cognitive behavioral therapy (CBT) assistance. We include three levels of tasks in CBT-BENCH: I: Basic CBT knowledge acquisition, with the task of multiple-choice questions; II: Cognitive model understanding, with the tasks of cognitive distortion classification, primary core belief classification, and fine-grained core belief classification; III: Therapeutic response generation, with the task of generating responses to patient speech in CBT therapy sessions. These tasks encompass key aspects of CBT that could potentially be enhanced through AI assistance, while also outlining a hierarchy of capability requirements, ranging from basic knowledge recitation to engaging in real therapeutic conversations. We evaluated representative LLMs on our benchmark. Experimental results indicate that while LLMs perform well in reciting CBT knowledge, they fall short in complex real-world scenarios requiring deep analysis of patients' cognitive structures and generating effective responses, suggesting potential future work.
Key facts. Cited by 12 papers in the map (data through 14 Oct 2026). Builds on 9 of its 27 references that are in the map. First posted on arXiv 17 Oct 2024.
Builds on
9 of 27 references.
References · 9
- 2023Cognitive Reframing of Negative Thoughts through Human-Language Model Interactioncited by 77
- 2021Towards Facilitating Empathic Conversations in Online Mental Health Support: A Reinforcement Learning Approachcited by 75
- 2024Roleplay-doh: Enabling Domain-Experts to Create LLM-simulated Patients via Eliciting and Adhering to Principlescited by 73
- 2023Facilitating Self-Guided Mental Health Interventions Through Human-Language Model Interaction: A Case Study of Cognitive Restructuringcited by 53
- 2023Training Models to Generate, Recognize, and Reframe Unhelpful Thoughtscited by 31
- 2023Empowering Psychotherapy with Large Language Models: Cognitive Distortion Detection through Diagnosis of Thought Promptingcited by 31
- 2024Risks from Language Models for Automated Mental Healthcare: Ethics and Structure for Implementationcited by 27
- 2023Rethinking Large Language Models in Mental Health Applicationscited by 16
- 2024mhGPT: A Lightweight Generative Pre-Trained Transformer for Mental Health Text Analysiscited by 5
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Citing papers per year: 2025: 3; 2026: 9.
12 papers.
- 2025Preference Learning Unlocks LLMs' Psycho-Counseling Skillscited by 10
- 2025MindEval: Benchmarking Language Models on Multi-turn Mental Health Supportcited by 10
- 2026PsychAgent: An Experience-Driven Lifelong Learning Agent for Self-Evolving Psychological Counselorcited by 3
- 2026TrustMH-Bench: A Comprehensive Benchmark for Evaluating the Trustworthiness of Large Language Models in Mental Healthcited by 2
- 2026TherapyGym: Evaluating and Aligning Clinical Fidelity and Safety in Therapy Chatbotscited by 1
- 2026Auditing Stealth Sycophancy in Mental-Health Dialogue: Structured Clinical-State Diagnostics and Clean Matched Benchmarkscited by 1
- 2026Where do LLMs Fall Short in CBT-Guided Affective Reasoning?cited by 1
- 2026MentalHospital: A Virtual Environment for Evaluating Psychiatric Clinical Encounterscited by 1
- 2025When LLM Therapists Become Salespeople: Evaluating Large Language Models for Ethical Motivational Interviewingcited by 0
- 2026CBT-Audio: Evaluating Audio Language Models for Patient-Side Distress Intensity Estimation in CBT Session Recordingscited by 0
- 2026Towards Understanding and Measuring COGNITIVE ATROPHY in LLM Behaviourcited by 0
- 2026From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Healthcited by 0
- 2026From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Health21 Sep 2026
- 2026MentalHospital: A Virtual Environment for Evaluating Psychiatric Clinical Encounters9 Jul 2026
- 2026Where do LLMs Fall Short in CBT-Guided Affective Reasoning?3 Jul 2026
- 2026Towards Understanding and Measuring COGNITIVE ATROPHY in LLM Behaviour16 Jun 2026
- 2026CBT-Audio: Evaluating Audio Language Models for Patient-Side Distress Intensity Estimation in CBT Session Recordings17 May 2026
- 2026Auditing Stealth Sycophancy in Mental-Health Dialogue: Structured Clinical-State Diagnostics and Clean Matched Benchmarks5 May 2026
- 2026PsychAgent: An Experience-Driven Lifelong Learning Agent for Self-Evolving Psychological Counselor1 Apr 2026
- 2026TrustMH-Bench: A Comprehensive Benchmark for Evaluating the Trustworthiness of Large Language Models in Mental Health3 Mar 2026
- 2026TherapyGym: Evaluating and Aligning Clinical Fidelity and Safety in Therapy Chatbots23 Feb 2026
- 2025MindEval: Benchmarking Language Models on Multi-turn Mental Health Support23 Nov 2025
- 2025When LLM Therapists Become Salespeople: Evaluating Large Language Models for Ethical Motivational Interviewing30 Mar 2025
- 2025Preference Learning Unlocks LLMs' Psycho-Counseling Skills27 Feb 2025