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"Is This Really a Human Peer Supporter?": Misalignments Between Peer Supporters and Experts in LLM-Supported Interactions

arXiv 2506.09354 ↗First posted 11 Jun 2025cs.HC cs.AIcited by 0

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Abstract (arXiv)

Mental health is a growing global concern, prompting interest in AI-driven solutions to expand access to psychosocial support. Peer support, grounded in lived experience, offers a valuable complement to professional care. However, variability in training, effectiveness, and definitions raises concerns about quality, consistency, and safety. Large Language Models (LLMs) present new opportunities to enhance peer support interactions, particularly in real-time, text-based interactions. We present and evaluate an AI-supported system with an LLM-simulated distressed client (SimClient), context-sensitive LLM-generated suggestions (Suggestions), and real-time emotion visualisations. 2 mixed-methods studies with 12 peer supporters and 6 mental health professionals (i.e., experts) examined the system's effectiveness and implications for practice. Both groups recognised its potential to enhance training and improve interaction quality. However, we found a key tension emerged: while peer supporters engaged meaningfully, experts consistently flagged critical issues in peer supporter responses, such as missed distress cues and premature advice-giving. This misalignment highlights potential limitations in current peer support training, especially in emotionally charged contexts where safety and fidelity to best practices are essential. Our findings underscore the need for standardised, psychologically grounded training, especially as peer support scales globally. They also demonstrate how LLM-supported systems can scaffold this development--if designed with care and guided by expert oversight. This work contributes to emerging conversations on responsible AI integration in mental health and the evolving role of LLMs in augmenting peer-delivered care.

Key facts. No citing papers in the map yet (data through 7 Oct 2026). Builds on 25 of its 125 references that are in the map. First posted on arXiv 11 Jun 2025.

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25 of 125 references.

References · 25

  1. 2020MIME: MIMicking Emotions for Empathetic Response Generationcited by 114
  2. 2021Towards Facilitating Empathic Conversations in Online Mental Health Support: A Reinforcement Learning Approachcited by 75
  3. 2024Roleplay-doh: Enabling Domain-Experts to Create LLM-simulated Patients via Eliciting and Adhering to Principlescited by 72
  4. 2022Human-AI Collaboration Enables More Empathic Conversations in Text-based Peer-to-Peer Mental Health Supportcited by 68
  5. 2023Mental-LLM: Leveraging Large Language Models for Mental Health Prediction via Online Text Datacited by 66
  6. 2023MindfulDiary: Harnessing Large Language Model to Support Psychiatric Patients' Journalingcited by 50
  7. 2022Large Language Models and the Reverse Turing Testcited by 38
  8. 2024ComPeer: A Generative Conversational Agent for Proactive Peer Supportcited by 24
  9. 2023Helping the Helper: Supporting Peer Counselors via AI-Empowered Practice and Feedbackcited by 23
  10. 2024The Typing Cure: Experiences with Large Language Model Chatbots for Mental Health Supportcited by 23
  11. 2024Towards a Client-Centered Assessment of LLM Therapists by Client Simulationcited by 23
  12. 2022Modeling Motivational Interviewing Strategies On An Online Peer-to-Peer Counseling Platformcited by 20
13 more
  1. 2024Understanding the Therapeutic Relationship between Counselors and Clients in Online Text-based Counseling using LLMscited by 19
  2. 2025As Confidence Aligns: Exploring the Effect of AI Confidence on Human Self-confidence in Human-AI Decision Makingcited by 18
  3. 2024Multi-Level Feedback Generation with Large Language Models for Empowering Novice Peer Counselorscited by 16
  4. 2024The Role of AI in Peer Support for Young People: A Study of Preferences for Human- and AI-Generated Responsescited by 15
  5. 2024"It was 80% me, 20% AI": Seeking Authenticity in Co-Writing with Large Language Modelscited by 14
  6. 2025Consistent Client Simulation for Motivational Interviewing-based Counselingcited by 14
  7. 2025Scaffolding Empathy: Training Counselors with Simulated Patients and Utterance-level Performance Visualizationscited by 14
  8. 2025Can LLM-Simulated Practice and Feedback Upskill Human Counselors? A Randomized Study with 90+ Novice Counselorscited by 13
  9. 2025Exploring Socio-Cultural Challenges and Opportunities in Designing Mental Health Chatbots for Adolescents in Indiacited by 5
  10. 2024Towards Understanding Emotions for Engaged Mental Health Conversationscited by 3
  11. 2025Envisioning an AI-Enhanced Mental Health Ecosystemcited by 2
  12. 2021Social Behaviour Understanding using Deep Neural Networks: Development of Social Intelligence Systemscited by 1
  13. 2025Conversational Self-Play for Discovering and Understanding Psychotherapy Approachescited by 1

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