arXiv subjects

Maya D'Eon

Publications and source records attributed to Maya D'Eon.

4 recordsLinked to original sources

arXiv2026

Move by Move: Measuring and Steering How LLMs Conduct Psychotherapy

Users increasingly turn to large language models for emotional support, yet little is known about how these models actually conduct a psychotherapy interaction. We introduce an ontology of ten therapeutic moves: compact, function-based categories grounded in the MULTI-60 inventory, validated through an annotation campaign with five licensed psychologists, and scaled with a judge-based approach that matches expert agreement. Applying it to real counseling transcripts and model-led sessions, we compare the move distributions between human clinicians and a panel of frontier models. Models over-use inquiry at up to three times the human rate, neglect psychoeducation, and are strongly context-anchored: they carry forward strategies initiated by a human clinician but rarely initiate them themselves. Exposing the ontology as a set of tools roughly halves the mean deviation from the human move distribution and improves turn-level alignment with human therapist by 7-9 percentage points, without any fine-tuning.

cs.CL↗

arXiv2026

Risk Governance for Generative AI Mental Health Support: A Multi-Turn Safety Architecture

Large language models (LLMs) are increasingly used for emotional support despite lacking mechanisms to safely govern evolving mental health risk. Existing safety approaches primarily detect risk but rarely shape how models respond as conversational risk unfolds. We developed a model-agnostic safety governance architecture that combines contextual risk detection, reasoning-based verification, and protocol-guided response generation for multi-turn mental health interactions. Synthetic conversations grounded in real-world mental health narratives were used to evaluate the architecture's performance, tested with GPT-5-chat and Qwen3.5-27B, achieving high risk detection performance (specificity: 0.85 (95\%CI: 0.78;0.91), sensitivity: 0.92 (95\%CI: 0.88;0.95)) and increasing clinician-preferred escalation responses by 25.6--59.2pp while preserving rapport and connection. Performance remained stable across conversation length and generalized across both proprietary and open-source models. These findings demonstrate that clinically-grounded safety governance can extend beyond risk detection to improve how LLMs manage evolving mental health risk, providing a scalable framework for safer deployment across models.

cs.AI↗

arXiv2026

MindGuard: Guardrail Classifiers for Multi-Turn Mental Health Support

Large language models are increasingly used for mental health support, yet their conversational coherence alone does not ensure clinical appropriateness. Existing general-purpose safeguards often fail to distinguish between therapeutic disclosures and genuine clinical crises, leading to safety failures. To address this gap, we introduce a clinically grounded risk taxonomy, developed in collaboration with PhD-level psychologists, that identifies actionable harm (e.g., self-harm and harm to others) while preserving space for safe, non-crisis therapeutic content. We release MindGuard-testset, a dataset of real-world multi-turn conversations annotated at the turn level by clinical experts. Using synthetic dialogues generated via a controlled two-agent setup, we train MindGuard, a family of lightweight safety classifiers (with 4B and 8B parameters). Our classifiers reduce false positives at high-recall operating points and, when paired with clinician language models, help achieve lower attack success and harmful engagement rates in adversarial multi-turn interactions compared to general-purpose safeguards. We release all models and human evaluation data.

cs.AI↗

arXiv2025

MindEval: Benchmarking Language Models on Multi-turn Mental Health Support

Demand for mental health support through AI chatbots is surging, though current systems present several limitations, like sycophancy or overvalidation, and reinforcement of maladaptive beliefs. A core obstacle to the creation of better systems is the scarcity of benchmarks that capture the complexity of real therapeutic interactions. Most existing benchmarks either only test clinical knowledge through multiple-choice questions or assess single responses in isolation. To bridge this gap, we present MindEval, a framework designed in collaboration with Ph.D-level Licensed Clinical Psychologists for automatically evaluating language models in realistic, multi-turn mental health therapy conversations. Through patient simulation and automatic evaluation with LLMs, our framework balances resistance to gaming with reproducibility via its fully automated, model-agnostic design. We begin by quantitatively validating the realism of our simulated patients against human-generated text and by demonstrating strong correlations between automatic and human expert judgments. Then, we evaluate 12 state-of-the-art LLMs and show that all models struggle, scoring below 4 out of 6, on average, with particular weaknesses in problematic AI-specific patterns of communication. Notably, reasoning capabilities and model scale do not guarantee better performance, and systems deteriorate with longer interactions or when supporting patients with severe symptoms. We release all code, prompts, and human evaluation data.

cs.CL↗