Motivational Interviewing (MI) is a counseling technique that promotes behavioral change through reflective responses to mirror or refine client statements. While advanced Large Language Models (LLMs) can generate engaging dialogues, challenges remain for applying them in a sensitive context such as MI. This work assesses the potential of LLMs to generate MI reflections via three LLMs: GPT-4, Llama-2, and BLOOM, and explores the effect of dialogue context size and integration of MI strategies for reflection generation by LLMs. We conduct evaluations using both automatic metrics and human judges on four criteria: appropriateness, relevance, engagement, and naturalness, to assess whether these LLMs can accurately generate the nuanced therapeutic communication required in MI. While we demonstrate LLMs’ potential in generating MI reflections comparable to human therapists, content analysis shows that significant challenges remain. By identifying the strengths and limitations of LLMs in generating empathetic and contextually appropriate reflections in MI, this work contributes to the ongoing dialogue in enhancing LLM’s role in therapeutic counseling.

Recent advancements in large language models (LLMs) have shown promise in generating psychotherapeutic dialogues, particularly in the context of motivational interviewing (MI). However, the inherent lack of transparency in LLM outputs presents significant challenges given the sensitive nature of psychotherapy. Applying MI strategies, a set of MI skills, to generate more controllable therapeutic-adherent conversations with explainability provides a possible solution. In this work, we explore the alignment of LLMs with MI strategies by first prompting the LLMs to predict the appropriate strategies as reasoning and then utilizing these strategies to guide the subsequent dialogue generation. We seek to investigate whether such alignment leads to more controllable and explainable generations. Multiple experiments including automatic and human evaluations are conducted to validate the effectiveness of MI strategies in aligning psychotherapy dialogue generation. Our findings demonstrate the potential of LLMs in producing strategically aligned dialogues and suggest directions for practical applications in psychotherapeutic settings.

Behavioral coding (BC) in motivational interviewing (MI) holds great potential for enhancing the efficacy of MI counseling. However, manual coding is labor-intensive, and automation efforts are hindered by the lack of data due to the privacy of psychotherapy. To address these challenges, we introduce BiMISC, a bilingual dataset of MI conversations in English and Dutch, sourced from real counseling sessions. Expert annotations in BiMISC adhere strictly to the motivational interviewing skills code (MISC) scheme, offering a pivotal resource for MI research. Additionally, we present a novel approach to elicit the MISC expertise from Large language models (LLMs) for MI coding. Through the in-depth analysis of BiMISC and the evaluation of our proposed approach, we demonstrate that the LLM-based approach yields results closely aligned with expert annotations and maintains consistent performance across different languages. Our contributions not only furnish the MI community with a valuable bilingual dataset but also spotlight the potential of LLMs in MI coding, laying the foundation for future MI research.

This paper describes the L2TOR intelligent tutoring system (ITS), focusing primarily on its output generation module. The L2TOR ITS is developed for the purpose of investigating the efficacy of robot-assisted second language tutoring in early childhood. We explain the process of generating contextually-relevant utterances, such as task-specific feedback messages, and discuss challenges regarding multimodality and multilingualism for situated natural language generation from a robot tutoring perspective.