# CAMI: A Counselor Agent Supporting Motivational Interviewing through State Inference and Topic Exploration

arXiv: https://arxiv.org/abs/2502.02807 · HTML: https://mlsanity.com/paper/2502.02807/

## Key facts

- Cited by 11 papers in the map (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 11 of its 38 references that are in the map.
- First posted on arXiv 5 Feb 2025.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 11 of 11)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Efficient Memory Management for Large Language Model Serving with PagedAttention](https://mlsanity.com/paper/2309.06180/) (2023)
- [OpenAssistant Conversations -- Democratizing Large Language Model Alignment](https://mlsanity.com/paper/2304.07327/) (2023)
- [Large Language Model Alignment: A Survey](https://mlsanity.com/paper/2309.15025/) (2023)
- [A Computational Framework for Behavioral Assessment of LLM Therapists](https://mlsanity.com/paper/2401.00820/) (2024)
- [Can Large Language Models be Good Emotional Supporter? Mitigating Preference Bias on Emotional Support Conversation](https://mlsanity.com/paper/2402.13211/) (2024)
- [Towards a Client-Centered Assessment of LLM Therapists by Client Simulation](https://mlsanity.com/paper/2406.12266/) (2024)
- [Modeling Motivational Interviewing Strategies On An Online Peer-to-Peer Counseling Platform](https://mlsanity.com/paper/2211.05182/) (2022)
- [Virtual Agents for Alcohol Use Counseling: Exploring LLM-Powered Motivational Interviewing](https://mlsanity.com/paper/2407.08095/) (2024)
- [Few-shot Dialogue Strategy Learning for Motivational Interviewing via Inductive Reasoning](https://mlsanity.com/paper/2403.15737/) (2024)
- [Speaker Verification in Agent-Generated Conversations](https://mlsanity.com/paper/2405.10150/) (2024)

## Built on by (most cited first, 11 of 11)

- [From LLM Reasoning to Autonomous AI Agents: A Comprehensive Review](https://mlsanity.com/paper/2504.19678/) (2025)
- [PatientHub: A Unified Framework for Patient Simulation](https://mlsanity.com/paper/2602.11684/) (2026)
- [CALM-IT: Enhancing Synthetic Motivational Interviewing Dialogue Quality with Conversational Dynamics](https://mlsanity.com/paper/2601.10085/) (2026)
- [MHSafeEval: Role-Aware Interaction-Level Evaluation of Mental Health Safety in Large Language Models](https://mlsanity.com/paper/2604.17730/) (2026)
- [Know You Before You Speak: User-State Modeling for LLM Personalization in Multi-Turn Conversation](https://mlsanity.com/paper/2605.24647/) (2026)
- [Responsible Evaluation of AI for Mental Health](https://mlsanity.com/paper/2602.00065/) (2026)
- [Proactive Service Agents: A Unified Decision Framework, Methods, and Evaluation](https://mlsanity.com/paper/2609.03727/) (2026)
- [Benchmarking Motivational Interviewing Competence of Large Language Models](https://mlsanity.com/paper/2603.03846/) (2026)
- [MIThinker: A Plug-and-Play Policy-Optimized Thinker For Motivational Interviewing Counseling](https://mlsanity.com/paper/2606.29265/) (2026)
- [From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Health](https://mlsanity.com/paper/2609.25186/) (2026)
- [BiGraph-Diffuse: A Bidirectional Diffusion Language Model with Graph-Structured Retrieval For Mental Health Counseling](https://mlsanity.com/paper/2609.29519/) (2026)

## Abstract (arXiv)

Conversational counselor agents have become essential tools for addressing the rising demand for scalable and accessible mental health support. This paper introduces CAMI, a novel automated counselor agent grounded in Motivational Interviewing (MI) -- a client-centered counseling approach designed to address ambivalence and facilitate behavior change. CAMI employs a novel STAR framework, consisting of client's state inference, motivation topic exploration, and response generation modules, leveraging large language models (LLMs). These components work together to evoke change talk, aligning with MI principles and improving counseling outcomes for clients from diverse backgrounds. We evaluate CAMI's performance through both automated and manual evaluations, utilizing simulated clients to assess MI skill competency, client's state inference accuracy, topic exploration proficiency, and overall counseling success. Results show that CAMI not only outperforms several state-of-the-art methods but also shows more realistic counselor-like behavior. Additionally, our ablation study underscores the critical roles of state inference and topic exploration in achieving this performance.