Evaluating an LLM-Powered Chatbot for Cognitive Restructuring: Insights from Mental Health Professionals

Fuente: arXiv
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Auteurs principaux: Wang, Yinzhou, Wang, Yimeng, Xiao, Ye, Escamilla, Liabette, Augustine, Bianca, Crace, Kelly, Zhou, Gang, Zhang, Yixuan
Format: Preprint
Publié: 2025
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author Wang, Yinzhou
Wang, Yimeng
Xiao, Ye
Escamilla, Liabette
Augustine, Bianca
Crace, Kelly
Zhou, Gang
Zhang, Yixuan
author_facet Wang, Yinzhou
Wang, Yimeng
Xiao, Ye
Escamilla, Liabette
Augustine, Bianca
Crace, Kelly
Zhou, Gang
Zhang, Yixuan
contents Recent advancements in large language models (LLMs) promise to expand mental health interventions by emulating therapeutic techniques, potentially easing barriers to care. Yet there is a lack of real-world empirical evidence evaluating the strengths and limitations of LLM-enabled psychotherapy interventions. In this work, we evaluate an LLM-powered chatbot, designed via prompt engineering to deliver cognitive restructuring (CR), with 19 users. Mental health professionals then examined the resulting conversation logs to uncover potential benefits and pitfalls. Our findings indicate that an LLM-based CR approach has the capability to adhere to core CR protocols, prompt Socratic questioning, and provide empathetic validation. However, issues of power imbalances, advice-giving, misunderstood cues, and excessive positivity reveal deeper challenges, including the potential to erode therapeutic rapport and ethical concerns. We also discuss design implications for leveraging LLMs in psychotherapy and underscore the importance of expert oversight to mitigate these concerns, which are critical steps toward safer, more effective AI-assisted interventions.
format Preprint
id arxiv_https___arxiv_org_abs_2501_15599
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Evaluating an LLM-Powered Chatbot for Cognitive Restructuring: Insights from Mental Health Professionals
Wang, Yinzhou
Wang, Yimeng
Xiao, Ye
Escamilla, Liabette
Augustine, Bianca
Crace, Kelly
Zhou, Gang
Zhang, Yixuan
Human-Computer Interaction
Recent advancements in large language models (LLMs) promise to expand mental health interventions by emulating therapeutic techniques, potentially easing barriers to care. Yet there is a lack of real-world empirical evidence evaluating the strengths and limitations of LLM-enabled psychotherapy interventions. In this work, we evaluate an LLM-powered chatbot, designed via prompt engineering to deliver cognitive restructuring (CR), with 19 users. Mental health professionals then examined the resulting conversation logs to uncover potential benefits and pitfalls. Our findings indicate that an LLM-based CR approach has the capability to adhere to core CR protocols, prompt Socratic questioning, and provide empathetic validation. However, issues of power imbalances, advice-giving, misunderstood cues, and excessive positivity reveal deeper challenges, including the potential to erode therapeutic rapport and ethical concerns. We also discuss design implications for leveraging LLMs in psychotherapy and underscore the importance of expert oversight to mitigate these concerns, which are critical steps toward safer, more effective AI-assisted interventions.
title Evaluating an LLM-Powered Chatbot for Cognitive Restructuring: Insights from Mental Health Professionals
topic Human-Computer Interaction
url https://arxiv.org/abs/2501.15599