Understanding the Therapeutic Relationship between Counselors and Clients in Online Text-based Counseling using LLMs

Anqi Li, Yu Lu, Nirui Song, Shuai Zhang, Lizhi Ma, Zhenzhong Lan


Abstract
Robust therapeutic relationships between counselors and clients are fundamental to counseling effectiveness. The assessment of therapeutic alliance is well-established in traditional face-to-face therapy but may not directly translate to text-based settings. With millions of individuals seeking support through online text-based counseling, understanding the relationship in such contexts is crucial.In this paper, we present an automatic approach using large language models (LLMs) to understand the development of therapeutic alliance in text-based counseling. We adapt a theoretically grounded framework specifically to the context of online text-based counseling and develop comprehensive guidelines for characterizing the alliance. We collect a comprehensive counseling dataset and conduct multiple expert evaluations on a subset based on this framework. Our LLM-based approach, combined with guidelines and simultaneous extraction of supportive evidence underlying its predictions, demonstrates effectiveness in identifying the therapeutic alliance. Through further LLM-based evaluations on additional conversations, our findings underscore the challenges counselors face in cultivating strong online relationships with clients. Furthermore, we demonstrate the potential of LLM-based feedback mechanisms to enhance counselors’ ability to build relationships, supported by a small-scale proof-of-concept.
Anthology ID:
2024.findings-emnlp.69
Volume:
Findings of the Association for Computational Linguistics: EMNLP 2024
Month:
November
Year:
2024
Address:
Miami, Florida, USA
Editors:
Yaser Al-Onaizan, Mohit Bansal, Yun-Nung Chen
Venue:
Findings
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
1280–1303
Language:
URL:
https://aclanthology.org/2024.findings-emnlp.69
DOI:
Bibkey:
Cite (ACL):
Anqi Li, Yu Lu, Nirui Song, Shuai Zhang, Lizhi Ma, and Zhenzhong Lan. 2024. Understanding the Therapeutic Relationship between Counselors and Clients in Online Text-based Counseling using LLMs. In Findings of the Association for Computational Linguistics: EMNLP 2024, pages 1280–1303, Miami, Florida, USA. Association for Computational Linguistics.
Cite (Informal):
Understanding the Therapeutic Relationship between Counselors and Clients in Online Text-based Counseling using LLMs (Li et al., Findings 2024)
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PDF:
https://aclanthology.org/2024.findings-emnlp.69.pdf