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Main Authors: Kumar, Vivek, Rajawat, Pushpraj Singh, Ntoutsi, Eirini
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2511.22818
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author Kumar, Vivek
Rajawat, Pushpraj Singh
Ntoutsi, Eirini
author_facet Kumar, Vivek
Rajawat, Pushpraj Singh
Ntoutsi, Eirini
contents Recent advancements in large language models (LLMs) have shown their potential across both general and domain-specific tasks. However, there is a growing concern regarding their lack of sensitivity, factual incorrectness in responses, inconsistent expressions of empathy, bias, hallucinations, and overall inability to capture the depth and complexity of human understanding, especially in low-resource and sensitive domains such as psychology. To address these challenges, our study employs a mixed-methods approach to evaluate the efficacy of LLMs in psychotherapy. We use LLMs to generate precise summaries of motivational interviewing (MI) dialogues and design a two-stage annotation scheme based on key components of the Motivational Interviewing Treatment Integrity (MITI) framework, namely evocation, collaboration, autonomy, direction, empathy, and a non-judgmental attitude. Using expert-annotated MI dialogues as ground truth, we formulate multi-class classification tasks to assess model performance under progressive prompting techniques, incorporating one-shot and few-shot prompting. Our results offer insights into LLMs' capacity for understanding complex psychological constructs and highlight best practices to mitigate ``semantic drift" in therapeutic settings. Our work contributes not only to the MI community by providing a high-quality annotated dataset to address data scarcity in low-resource domains but also critical insights for using LLMs for precise contextual interpretation in complex behavioral therapy.
format Preprint
id arxiv_https___arxiv_org_abs_2511_22818
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Mitigating Semantic Drift: Evaluating LLMs' Efficacy in Psychotherapy through MI Dialogue Summarization
Kumar, Vivek
Rajawat, Pushpraj Singh
Ntoutsi, Eirini
Computation and Language
Machine Learning
Recent advancements in large language models (LLMs) have shown their potential across both general and domain-specific tasks. However, there is a growing concern regarding their lack of sensitivity, factual incorrectness in responses, inconsistent expressions of empathy, bias, hallucinations, and overall inability to capture the depth and complexity of human understanding, especially in low-resource and sensitive domains such as psychology. To address these challenges, our study employs a mixed-methods approach to evaluate the efficacy of LLMs in psychotherapy. We use LLMs to generate precise summaries of motivational interviewing (MI) dialogues and design a two-stage annotation scheme based on key components of the Motivational Interviewing Treatment Integrity (MITI) framework, namely evocation, collaboration, autonomy, direction, empathy, and a non-judgmental attitude. Using expert-annotated MI dialogues as ground truth, we formulate multi-class classification tasks to assess model performance under progressive prompting techniques, incorporating one-shot and few-shot prompting. Our results offer insights into LLMs' capacity for understanding complex psychological constructs and highlight best practices to mitigate ``semantic drift" in therapeutic settings. Our work contributes not only to the MI community by providing a high-quality annotated dataset to address data scarcity in low-resource domains but also critical insights for using LLMs for precise contextual interpretation in complex behavioral therapy.
title Mitigating Semantic Drift: Evaluating LLMs' Efficacy in Psychotherapy through MI Dialogue Summarization
topic Computation and Language
Machine Learning
url https://arxiv.org/abs/2511.22818