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Challenges of Large Language Models for Mental Health Counseling

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arxiv 2311.13857 v1 pith:6DFVQA7A submitted 2023-11-23 cs.CL cs.AIcs.HC

classification cs.CLcs.AIcs.HC
keywords mentalhealthllmschallengescounselingeffectivenesslanguagelarge
verification ladder T0 review T1 audit T2 compute T3 formal
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The global mental health crisis is looming with a rapid increase in mental disorders, limited resources, and the social stigma of seeking treatment. As the field of artificial intelligence (AI) has witnessed significant advancements in recent years, large language models (LLMs) capable of understanding and generating human-like text may be used in supporting or providing psychological counseling. However, the application of LLMs in the mental health domain raises concerns regarding the accuracy, effectiveness, and reliability of the information provided. This paper investigates the major challenges associated with the development of LLMs for psychological counseling, including model hallucination, interpretability, bias, privacy, and clinical effectiveness. We explore potential solutions to these challenges that are practical and applicable to the current paradigm of AI. From our experience in developing and deploying LLMs for mental health, AI holds a great promise for improving mental health care, if we can carefully navigate and overcome pitfalls of LLMs.

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Cited by 3 Pith papers

Reviewed papers in the Pith corpus that reference this work. Sorted by Pith novelty score. OpenAlex reports about 8 citations worldwide. Full citation record

  1. Alignment Plausibility: A New Standard for Assuring AI in Healthcare

    cs.AI 2026-07 conditional novelty 5.5 of 10

    Alignment plausibility—evidence that an AI system's values, training, and oversight cohere with safe positive health outcomes—should be the regulatory analogue of biological plausibility for LLMs in healthcare.

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  3. AI-Augmented LLMs Achieve Therapist-Level Responses in Motivational Interviewing

    cs.CL 2025-05 reject novelty 4.0 of 10

    A custom prompt built from machine-learning-identified therapy behavior features improved GPT-4's motivational interviewing quality scores, though the model remained slightly below human therapists on the paper's own metric.

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