Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling

• URL: http://arxiv.org/abs/2505.15715v1
• Date: Wed, 21 May 2025 16:24:49 GMT
• Title: Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling
• Authors: He Hu, Yucheng Zhou, Juzheng Si, Qianning Wang, Hengheng Zhang, Fuji Ren, Fei Ma, Laizhong Cui,
• Abstract summary: PsyLLM is a large language model designed to integrate diagnostic and therapeutic reasoning for mental health counseling.<n>This pipeline processes real-world mental health posts and generates multi-turn dialogue structures.<n> Rigorous multi-dimensional filtering ensures the generation of high-quality, clinically aligned dialogue data.
• Score: 17.809187205107232
• License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/
• Abstract: Large language models (LLMs) hold significant potential for mental health support, capable of generating empathetic responses and simulating therapeutic conversations. However, existing LLM-based approaches often lack the clinical grounding necessary for real-world psychological counseling, particularly in explicit diagnostic reasoning aligned with standards like the DSM/ICD and incorporating diverse therapeutic modalities beyond basic empathy or single strategies. To address these critical limitations, we propose PsyLLM, the first large language model designed to systematically integrate both diagnostic and therapeutic reasoning for mental health counseling. To develop the PsyLLM, we propose a novel automated data synthesis pipeline. This pipeline processes real-world mental health posts, generates multi-turn dialogue structures, and leverages LLMs guided by international diagnostic standards (e.g., DSM/ICD) and multiple therapeutic frameworks (e.g., CBT, ACT, psychodynamic) to simulate detailed clinical reasoning processes. Rigorous multi-dimensional filtering ensures the generation of high-quality, clinically aligned dialogue data. In addition, we introduce a new benchmark and evaluation protocol, assessing counseling quality across four key dimensions: comprehensiveness, professionalism, authenticity, and safety. Our experiments demonstrate that PsyLLM significantly outperforms state-of-the-art baseline models on this benchmark.

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