Fine-Tuning Large Audio-Language Models with LoRA for Precise Temporal Localization of Prolonged Exposure Therapy Elements

Fuente: arXiv
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Autori principali: BN, Suhas, Sherrill, Andrew M., Alaparthi, Jyoti, Mattioli, Dominik, Arriaga, Rosa I., Wiese, Chris W., Abdullah, Saeed
Natura: Preprint
Pubblicazione: 2025
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author BN, Suhas
Sherrill, Andrew M.
Alaparthi, Jyoti
Mattioli, Dominik
Arriaga, Rosa I.
Wiese, Chris W.
Abdullah, Saeed
author_facet BN, Suhas
Sherrill, Andrew M.
Alaparthi, Jyoti
Mattioli, Dominik
Arriaga, Rosa I.
Wiese, Chris W.
Abdullah, Saeed
contents Prolonged Exposure (PE) therapy is an effective treatment for post-traumatic stress disorder (PTSD), but evaluating therapist fidelity remains labor-intensive due to the need for manual review of session recordings. We present a method for the automatic temporal localization of key PE fidelity elements, identifying their start and stop times, directly from session audio and transcripts. Our approach fine-tunes a large pre-trained audio-language model, Qwen2-Audio, using Low-Rank Adaptation (LoRA) to process focused 30-second windows of audio-transcript input. Fidelity labels for three core protocol phases, therapist orientation (P1), imaginal exposure (P2), and post-imaginal processing (P3), are generated via LLM-based prompting and verified by trained raters. The model is trained to predict normalized boundary offsets using soft supervision guided by task-specific prompts. On a dataset of 308 real PE sessions, our best configuration (LoRA rank 8, 30s windows) achieves a mean absolute error (MAE) of 5.3s across tasks, within typical rater tolerance for timestamp review, enabling practical fidelity QC. We further analyze the effects of window size and LoRA rank, highlighting the importance of context granularity and model adaptation. This work introduces a privacy-preserving, scalable framework for fidelity tracking in PE therapy, with potential to support clinician training, supervision, and quality assurance.
format Preprint
id arxiv_https___arxiv_org_abs_2506_09707
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Fine-Tuning Large Audio-Language Models with LoRA for Precise Temporal Localization of Prolonged Exposure Therapy Elements
BN, Suhas
Sherrill, Andrew M.
Alaparthi, Jyoti
Mattioli, Dominik
Arriaga, Rosa I.
Wiese, Chris W.
Abdullah, Saeed
Audio and Speech Processing
Computation and Language
Human-Computer Interaction
68T07
I.2.7; I.5.4; H.5.2
Prolonged Exposure (PE) therapy is an effective treatment for post-traumatic stress disorder (PTSD), but evaluating therapist fidelity remains labor-intensive due to the need for manual review of session recordings. We present a method for the automatic temporal localization of key PE fidelity elements, identifying their start and stop times, directly from session audio and transcripts. Our approach fine-tunes a large pre-trained audio-language model, Qwen2-Audio, using Low-Rank Adaptation (LoRA) to process focused 30-second windows of audio-transcript input. Fidelity labels for three core protocol phases, therapist orientation (P1), imaginal exposure (P2), and post-imaginal processing (P3), are generated via LLM-based prompting and verified by trained raters. The model is trained to predict normalized boundary offsets using soft supervision guided by task-specific prompts. On a dataset of 308 real PE sessions, our best configuration (LoRA rank 8, 30s windows) achieves a mean absolute error (MAE) of 5.3s across tasks, within typical rater tolerance for timestamp review, enabling practical fidelity QC. We further analyze the effects of window size and LoRA rank, highlighting the importance of context granularity and model adaptation. This work introduces a privacy-preserving, scalable framework for fidelity tracking in PE therapy, with potential to support clinician training, supervision, and quality assurance.
title Fine-Tuning Large Audio-Language Models with LoRA for Precise Temporal Localization of Prolonged Exposure Therapy Elements
topic Audio and Speech Processing
Computation and Language
Human-Computer Interaction
68T07
I.2.7; I.5.4; H.5.2
url https://arxiv.org/abs/2506.09707