Multi-dimensional Assessment and Explainable Feedback for Counselor Responses to Client Resistance in Text-based Counseling with LLMs
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Abstract (arXiv)
Effectively addressing client resistance is a sophisticated clinical skill in psychological counseling, yet practitioners often lack timely and scalable supervisory feedback to refine their approaches. Although current NLP research has examined overall counseling quality and general therapeutic skills, it fails to provide granular evaluations of high-stakes moments where clients exhibit resistance. In this work, we present a comprehensive pipeline for the multi-dimensional evaluation of human counselors' interventions specifically targeting client resistance in text-based therapy. We introduce a theory-driven framework that decomposes counselor responses into four distinct communication mechanisms. Leveraging this framework, we curate and share an expert-annotated dataset of real-world counseling excerpts, pairing counselor-client interactions with professional ratings and explanatory rationales. Using this data, we perform full-parameter instruction tuning on a Llama-3.1-8B-Instruct backbone to model fine-grained evaluative judgments of response quality and generate explanations underlying. Experimental results show that our approach can effectively distinguish the quality of different communication mechanisms (77-81% F1), substantially outperforming GPT-4o and Claude-3.5-Sonnet (45-59% F1). Moreover, the model produces high-quality explanations that closely align with expert references and receive near-ceiling ratings from human experts (2.8-2.9/3.0). A controlled experiment with 43 counselors further confirms that receiving these AI-generated feedback significantly improves counselors' ability to respond effectively to client resistance.
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References · 10
- 2023GPT-4 Technical Reportcited by 18,132
- 2024Qwen2.5 Technical Reportcited by 4,713
- 2020A Computational Approach to Understanding Empathy Expressed in Text-Based Mental Health Supportcited by 182
- 2019Observing Dialogue in Therapy: Categorizing and Forecasting Behavioral Codescited by 25
- 2023Helping the Helper: Supporting Peer Counselors via AI-Empowered Practice and Feedbackcited by 23
- 2024Understanding the Therapeutic Relationship between Counselors and Clients in Online Text-based Counseling using LLMscited by 19
- 2024Multi-Level Feedback Generation with Large Language Models for Empowering Novice Peer Counselorscited by 16
- 2023Understanding Client Reactions in Online Mental Health Counselingcited by 9
- 2024Predicting the Big Five Personality Traits in Chinese Counselling Dialogues Using Large Language Modelscited by 7
- 2026RECAP: Resistance Capture in Text-based Mental Health Counseling with Large Language Modelscited by 2
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