# MACBT: A Multi-Agent Cognitive Behavioral Therapy Decision Support System with Longitudinal Memory

arXiv: https://arxiv.org/abs/2609.30939 · HTML: https://mlsanity.com/paper/2609.30939/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 17 of its 32 references that are in the map.
- First posted on arXiv 25 Sep 2026.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 17 of 17)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [Generative Agents: Interactive Simulacra of Human Behavior](https://mlsanity.com/paper/2304.03442/) (2023)
- [A-MEM: Agentic Memory for LLM Agents](https://mlsanity.com/paper/2502.12110/) (2025)
- [MemoryBank: Enhancing Large Language Models with Long-Term Memory](https://mlsanity.com/paper/2305.10250/) (2023)
- [SoulChat: Improving LLMs' Empathy, Listening, and Comfort Abilities through Fine-tuning with Multi-turn Empathy Conversations](https://mlsanity.com/paper/2311.00273/) (2023)
- [CPsyCoun: A Report-based Multi-turn Dialogue Reconstruction and Evaluation Framework for Chinese Psychological Counseling](https://mlsanity.com/paper/2405.16433/) (2024)
- [Cactus: Towards Psychological Counseling Conversations using Cognitive Behavioral Theory](https://mlsanity.com/paper/2407.03103/) (2024)
- [SMILE: Single-turn to Multi-turn Inclusive Language Expansion via ChatGPT for Mental Health Support](https://mlsanity.com/paper/2305.00450/) (2023)
- [AnnaAgent: Dynamic Evolution Agent System with Multi-Session Memory for Realistic Seeker Simulation](https://mlsanity.com/paper/2506.00551/) (2025)
- [MAGI: Multi-Agent Guided Interview for Psychiatric Assessment](https://mlsanity.com/paper/2504.18260/) (2025)
- [Psychological Counseling Cannot Be Achieved Overnight: Automated Psychological Counseling Through Multi-Session Conversations](https://mlsanity.com/paper/2506.06626/) (2025)
- [PsyChat: A Client-Centric Dialogue System for Mental Health Support](https://mlsanity.com/paper/2312.04262/) (2023)
- [MentalAgora: A Gateway to Advanced Personalized Care in Mental Health through Multi-Agent Debating and Attribute Control](https://mlsanity.com/paper/2407.02736/) (2024)
- [Advancing Conversational Psychotherapy: Integrating Privacy, Dual-Memory, and Domain Expertise with Large Language Models](https://mlsanity.com/paper/2412.02987/) (2024)

## Abstract (arXiv)

Cognitive behavioral therapy (CBT) is an evidence-based first-line treatment for depression, yet its scale is constrained by the time clinicians spend on pre-session preparation, post-session documentation, and longitudinal cognitive-pathology tracking. We present a clinician-facing AI decision-support system that combines a multi-agent CBT framework (MACBT) with a CBT-specific longitudinal memory module (CD Memory). MACBT encodes the five-stage CBT workflow (assessment, Socratic questioning, cognitive restructuring, behavioral experiments, and treatment monitoring) into five collaborative agents. CD Memory tracks cognitive-distortion type, frequency, severity, and restructuring efficacy across sessions to generate pre-session pathology reports and intervention-priority recommendations. We construct a Chinese CBT dialogue corpus via dual-role large language model simulation and train a Qwen3-14B backbone with supervised fine-tuning and direct preference optimization. Evaluation with GPT-4 judges shows MACBT outperforms MeChat, SoulChat, PsyChat, and CPsyCounX in professionalism (2.62) and clinical authenticity (2.25). The full memory-augmented system further improves session quality by 12.6% and achieves a longitudinal mean of 2.29 on cross-session continuity, intervention progression, and personalization.