Multimodal Cognitive Reframing Therapy via Multi-hop Psychotherapeutic Reasoning
On the map: LLM reasoning → Clinical and biomedical applications
Abstract (arXiv)
Previous research has revealed the potential of large language models (LLMs) to support cognitive reframing therapy; however, their focus was primarily on text-based methods, often overlooking the importance of non-verbal evidence crucial in real-life therapy. To alleviate this gap, we extend the textual cognitive reframing to multimodality, incorporating visual clues. Specifically, we present a new dataset called Multi Modal-Cognitive Support Conversation (M2CoSC), which pairs each GPT-4-generated dialogue with an image that reflects the virtual client's facial expressions. To better mirror real psychotherapy, where facial expressions lead to interpreting implicit emotional evidence, we propose a multi-hop psychotherapeutic reasoning approach that explicitly identifies and incorporates subtle evidence. Our comprehensive experiments with both LLMs and vision-language models (VLMs) demonstrate that the VLMs' performance as psychotherapists is significantly improved with the M2CoSC dataset. Furthermore, the multi-hop psychotherapeutic reasoning method enables VLMs to provide more thoughtful and empathetic suggestions, outperforming standard prompting methods.
Key facts. Cited by 7 papers in the map (data through 14 Oct 2026). Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning. Builds on 3 of its 35 references that are in the map. First posted on arXiv 8 Feb 2025.
Builds on
3 of 35 references.
References · 3
- 2023GPT-4 Technical Reportcited by 18,396
- 2023Llama 2: Open Foundation and Fine-Tuned Chat Modelscited by 13,028
- 2024A Computational Framework for Behavioral Assessment of LLM Therapistscited by 62
Built on by
Citing papers per year: 2025: 3; 2026: 4.
7 papers.
- 2025MIRROR: Multimodal Cognitive Reframing Therapy for Rolling with Resistancecited by 13
- 2025Crisp: Cognitive Restructuring of Negative Thoughts through Multi-turn Supportive Dialoguescited by 11
- 2025A Comprehensive Review of Datasets for Clinical Mental Health AI Systemscited by 3
- 2026Responsible Evaluation of AI for Mental Healthcited by 2
- 2026DMT-CBT: Longitudinal Therapeutic State Modeling for CBT Counselingcited by 1
- 2026Assessing the Effectiveness of LLMs in Delivering Cognitive Behavioral Therapycited 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
- 2026DMT-CBT: Longitudinal Therapeutic State Modeling for CBT Counseling2 Jun 2026
- 2026Assessing the Effectiveness of LLMs in Delivering Cognitive Behavioral Therapy4 Mar 2026
- 2026Responsible Evaluation of AI for Mental Health20 Jan 2026
- 2025A Comprehensive Review of Datasets for Clinical Mental Health AI Systems13 Aug 2025
- 2025Crisp: Cognitive Restructuring of Negative Thoughts through Multi-turn Supportive Dialogues24 Apr 2025
- 2025MIRROR: Multimodal Cognitive Reframing Therapy for Rolling with Resistance16 Apr 2025
Similar, not cited
Close in wording, no citation either way
- 2025Does "Reasoning" with Large Language Models Improve Recognizing, Generating, and Reframing Unhelpful Thoughts?
- 2025When and How to Integrate Multimodal Large Language Models in College Psychotherapy: Perspectives from Multi-stakeholders
- 2026Mind Companion: An Embodied Conversational Agent for Process-Based Psychotherapy
- 2026Where do LLMs Fall Short in CBT-Guided Affective Reasoning?
- 2023Empowering Psychotherapy with Large Language Models: Cognitive Distortion Detection through Diagnosis of Thought Prompting
- 2026MACBT: A Multi-Agent Cognitive Behavioral Therapy Decision Support System with Longitudinal Memory
- 2025Psy-Copilot: Visual Chain of Thought for Counseling
- 2025Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling