Preference Learning Unlocks LLMs' Psycho-Counseling Skills
On the map: LLM alignment / RLHF / preference optimisation → Medical LLM alignment
Abstract (arXiv)
Applying large language models (LLMs) to assist in psycho-counseling is an emerging and meaningful approach, driven by the significant gap between patient needs and the availability of mental health support. However, current LLMs struggle to consistently provide effective responses to client speeches, largely due to the lack of supervision from high-quality real psycho-counseling data, whose content is typically inaccessible due to client privacy concerns. Furthermore, the quality of therapists' responses in available sessions can vary significantly based on their professional training and experience. Assessing the quality of therapists' responses remains an open challenge. In this work, we address these challenges by first proposing a set of professional and comprehensive principles to evaluate therapists' responses to client speeches. Using these principles, we create a preference dataset, PsychoCounsel-Preference, which contains 36k high-quality preference comparison pairs. This dataset aligns with the preferences of professional psychotherapists, providing a robust foundation for evaluating and improving LLMs in psycho-counseling. Experiments on reward modeling and preference learning demonstrate that PsychoCounsel-Preference is an excellent resource for LLMs to acquire essential skills for responding to clients in a counseling session. Our best-aligned model, PsychoCounsel-Llama3-8B, achieves an impressive win rate of 87% against GPT-4o. We release PsychoCounsel-Preference, PsychoCounsel-Llama3-8B and the reward model PsychoCounsel Llama3-8B-Reward to facilitate the research of psycho-counseling with LLMs at: https://hf.co/Psychotherapy-LLM.
Key facts. Cited by 10 papers in the map (data through 14 Oct 2026). Placed in Medical LLM alignment, one of 10 directions in LLM alignment / RLHF / preference optimisation. Builds on 29 of its 45 references that are in the map. First posted on arXiv 27 Feb 2025.
Builds on
29 of 45 references.
References · 29
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- 2024RewardBench: Evaluating Reward Models for Language Modelingcited by 499
17 more
- 2024Skywork-Reward: Bag of Tricks for Reward Modeling in LLMscited by 327
- 2024OLMoE: Open Mixture-of-Experts Language Modelscited by 301
- 2024Is DPO Superior to PPO for LLM Alignment? A Comprehensive Studycited by 262
- 2024Iterative Reasoning Preference Optimizationcited by 246
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- 2024HelpSteer2-Preference: Complementing Ratings with Preferencescited by 130
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Built on by
Citing papers per year: 2025: 4; 2026: 6.
10 papers.
- 2025SoSBench: Benchmarking Safety Alignment on Six Scientific Domainscited by 12
- 2025TheraMind: A Strategic and Adaptive Agent for Longitudinal Psychological Counselingcited by 7
- 2025Adaptive Helpfulness-Harmlessness Alignment with Preference Vectorscited by 6
- 2025PersonaFuse: A Personality Activation-Driven Framework for Enhancing Human-LLM Interactionscited by 5
- 2026Do No Harm: Exposing Hidden Vulnerabilities of LLMs via Persona-based Client Simulation Attack in Psychological Counselingcited by 4
- 2026PSI-Bench: Interpretable and Clinically Meaningful Evaluation of Depression Patient Simulatorscited by 2
- 2026TherapyGym: Evaluating and Aligning Clinical Fidelity and Safety in Therapy Chatbotscited by 1
- 2026Discourse Diversity in Multi-Turn Empathic Dialoguecited by 1
- 2026From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Healthcited by 0
- 2026PsyEvo: A Personalized Counseling Agent That Self-Evolves at Test Timecited by 0
- 2026PsyEvo: A Personalized Counseling Agent That Self-Evolves at Test Time2 Oct 2026
- 2026From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Health21 Sep 2026
- 2026PSI-Bench: Interpretable and Clinically Meaningful Evaluation of Depression Patient Simulators28 Apr 2026
- 2026Discourse Diversity in Multi-Turn Empathic Dialogue13 Apr 2026
- 2026Do No Harm: Exposing Hidden Vulnerabilities of LLMs via Persona-based Client Simulation Attack in Psychological Counseling6 Apr 2026
- 2026TherapyGym: Evaluating and Aligning Clinical Fidelity and Safety in Therapy Chatbots23 Feb 2026
- 2025TheraMind: A Strategic and Adaptive Agent for Longitudinal Psychological Counseling29 Oct 2025
- 2025PersonaFuse: A Personality Activation-Driven Framework for Enhancing Human-LLM Interactions9 Sep 2025
- 2025SoSBench: Benchmarking Safety Alignment on Six Scientific Domains27 May 2025
- 2025Adaptive Helpfulness-Harmlessness Alignment with Preference Vectors27 Apr 2025
Similar, not cited
Close in wording, no citation either way
- 2025Psi-Arena: Interactive Assessment and Optimization of LLM-based Psychological Counselors with Tripartite Feedback
- 2026Assessing the Effectiveness of LLMs in Delivering Cognitive Behavioral Therapy
- 2024Domain-Specific Improvement on Psychotherapy Chatbot Using Assistant
- 2024Advancing Conversational Psychotherapy: Integrating Privacy, Dual-Memory, and Domain Expertise with Large Language Models
- 2024Do Large Language Models Align with Core Mental Health Counseling Competencies?
- 2025AI-Augmented LLMs Achieve Therapist-Level Responses in Motivational Interviewing
- 2026Multi-Objective Alignment of Language Models for Personalized Psychotherapy
- 2025PsychBench: A comprehensive and professional benchmark for evaluating the performance of LLM-assisted psychiatric clinical practice