DeepSAGE (Strategic AI Guidance Engine), a hybrid LLM--Deep Reinforcement Learning (DRL) framework for stage-aware counseling dialogue grounded in the first session of Cognitive Behavioral Therapy (CBT), suggests that combining stage-structured dialogue with learned strategy selection is a promising approach for AI counseling.
Abstract
Large Language Model (LLM)-based counseling agents can generate fluent and supportive responses, but they often lack the structured, goal-directed progression required to conduct a coherent therapeutic session. We present DeepSAGE (Strategic AI Guidance Engine), a hybrid LLM--Deep Reinforcement Learning (DRL) framework for stage-aware counseling dialogue grounded in the first session of Cognitive Behavioral Therapy (CBT). DeepSAGE represents the session as eleven stages with explicit therapeutic objectives, with an external controller determines stage completion and the DRL model selects therapeutic intentions that guide LLM response generation. We evaluate DeepSAGE against six retrieval-, prompting-, stage-, and policy-based alternatives. DeepSAGE elicits higher simulated client engagement and openness and achieves the strongest balance of stage-goal completion and dialogue efficiency among stage-structured systems. Domain expert review further indicates that the generated conversations exhibit broadly plausible emotional trajectories and recognizable CBT processes. Because the evaluation relies primarily on simulated clients and model-based metrics, these findings demonstrate comparative dialogue-control improvements rather than clinical effectiveness. These results suggest that combining stage-structured dialogue with learned strategy selection is a promising approach for AI counseling, though clinical effectiveness, safety, and real-world utility require further human evaluation.
ODRA is introduced, a novel framework for synthesizing therapy dialogues through a Chain-of-Thought (CoT) strategy grounded in foundational CBT guidelines, which significantly outperforms existing methods across therapeutic skills, CBT alignment, and patient behavioral fidelity.
Javier Rodríguez-Juan, Hiba Arnaout, J. García-Rodríguez et al.· 0 citations
Cognitive behavioral therapy (CBT) is an evidence-based first-line treatment for depression, yet its scale is constrained by the time clinicians spend on pre-session preparation, post-session documentation, and longitudinal cognitive-pathology tracking. We present a clinician-facing AI decision-support system that comb...
Deng-Du Jiang, Shuo Zhang, Wei-Wei Liao et al.· 0 citations
Abstract Background Psychotherapy training is difficult to scale because manual rating of motivational interviewing (MI) and cognitive behavioral therapy (CBT) sessions is time-intensive, requires trained raters, and is subject to rater variability. Large language models (LLMs) may support simulation-based training and...
M. A. Kamaleddin, Mina Mirjalili, Reza Barzegar et al.· JMIR Medical Education· 0 citations
Recent advancements in large language models have revolutionized the field of psychological counseling, especially in the context of Cognitive Behavioral Therapy (CBT). While the success of CBT relies heavily on dynamic decision-making informed by the client's real-time mental state, this aspect has often been overlook...
Zi-Mu Wang, Yi-Wen Jiang, Xiang-Yu Zhao et al.· 0 citations
Emotional Support Conversation (ESC) systems aim to provide holistic support by balancing professional therapeutic competence with natural empathy. However, existing methods struggle to simultaneously achieve structured, stage-aware reasoning and seamless empathy-expertise alignment, often resulting in an artificial sp...
Wei-Chuan Liu, Yuxuan Hu, Yi-Rong Sun et al.· 0 citations
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