# Toward expert-level motivational interviewing for health behavior improvement with LLMs

arXiv: https://arxiv.org/abs/2512.15446 · HTML: https://mlsanity.com/paper/2512.15446/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 13 of its 49 references that are in the map.
- First posted on arXiv 17 Dec 2025.

## Builds on (most cited first, 13 of 13)

- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Deep reinforcement learning from human preferences](https://mlsanity.com/paper/1706.03741/) (2017)
- [LlamaFactory: Unified Efficient Fine-Tuning of 100+ Language Models](https://mlsanity.com/paper/2403.13372/) (2024)
- [ChatGLM: A Family of Large Language Models from GLM-130B to GLM-4 All Tools](https://mlsanity.com/paper/2406.12793/) (2024)
- [Baichuan 2: Open Large-scale Language Models](https://mlsanity.com/paper/2309.10305/) (2023)
- [A Prompt Pattern Catalog to Enhance Prompt Engineering with ChatGPT](https://mlsanity.com/paper/2302.11382/) (2023)
- [Efficient and Effective Text Encoding for Chinese LLaMA and Alpaca](https://mlsanity.com/paper/2304.08177/) (2023)
- [CPsyCoun: A Report-based Multi-turn Dialogue Reconstruction and Evaluation Framework for Chinese Psychological Counseling](https://mlsanity.com/paper/2405.16433/) (2024)
- [SMILE: Single-turn to Multi-turn Inclusive Language Expansion via ChatGPT for Mental Health Support](https://mlsanity.com/paper/2305.00450/) (2023)
- [PsyDT: Using LLMs to Construct the Digital Twin of Psychological Counselor with Personalized Counseling Style for Psychological Counseling](https://mlsanity.com/paper/2412.13660/) (2024)
- [Unlocking LLMs: Addressing Scarce Data and Bias Challenges in Mental Health](https://mlsanity.com/paper/2412.12981/) (2024)
- [KMI: A Dataset of Korean Motivational Interviewing Dialogues for Psychotherapy](https://mlsanity.com/paper/2502.05651/) (2025)
- [A Fully Generative Motivational Interviewing Counsellor Chatbot for Moving Smokers Towards the Decision to Quit](https://mlsanity.com/paper/2505.17362/) (2025)

## Built on by (most cited first, 1 of 1)

- [Benchmarking Motivational Interviewing Competence of Large Language Models](https://mlsanity.com/paper/2603.03846/) (2026)

## Abstract (arXiv)

Background: Motivational interviewing (MI) is an effective counseling approach for promoting health behavior change, but its impact is constrained by the need for highly trained human counselors. Objective: This study aimed to explore a scalable alternative by developing and evaluating Large Language Models for Motivational Interviewing (MI-LLMs). Methods: We first curated five Chinese psychological counseling corpora and, using GPT-4 with an MI-informed prompt, transcribed multi-turn dialogues from the two highest-quality datasets (CPsyCounD and PsyDTCorpus) into 2,040 MI-style counseling conversations, of which 2,000 were used for training and 40 for testing. Three Chinese-capable open-source LLMs (Baichuan2-7B-Chat, ChatGLM-4-9B-Chat and Llama-3-8B-Chinese-Chat-v2) were fine-tuned on this corpus and were named as MI-LLMs. We evaluated MI-LLMs using round-based automatic metrics and expert manual coding with the Motivational Interviewing Treatment Integrity (MITI) Coding Manual 4.2.1. Results: Across all three models, fine-tuning substantially improved BLEU-4 and ROUGE scores compared with the base models, and manual coding showed that MI-LLMs achieved technical and relational global scores, and MI-adherent ratios that approached those of real MI dialogues, although complex reflections and reflection-to-question ratios remained less frequent. Conclusions: These findings provide initial evidence that MI-oriented fine-tuning can endow general-purpose LLMs with core MI-consistent counseling behaviors, suggesting a scalable pathway toward AI-assisted health behavior change support while underscoring the need for further work on data scale, complex MI skills and real-world intervention trials.