Agency, the capacity to proactively shape events, is central to how humans interact and collaborate. While LLMs are being developed to simulate human behavior and serve as human-like agents, little attention has been given to the Agency that these models should possess in order to proactively manage the direction of interaction and collaboration. In this paper, we investigate Agency as a desirable function of LLMs, and how it can be measured and managed. We build on social-cognitive theory to develop a framework of features through which Agency is expressed in dialogue – indicating what you intend to do (Intentionality), motivating your intentions (Motivation), having self-belief in intentions (Self-Efficacy), and being able to self-adjust (Self-Regulation). We collect a new dataset of 83 human-human collaborative interior design conversations containing 908 conversational snippets annotated for Agency features. Using this dataset, we develop methods for measuring Agency of LLMs. Automatic and human evaluations show that models that manifest features associated with high Intentionality, Motivation, Self-Efficacy, and Self-Regulation are more likely to be perceived as strongly agentive.

Navigating certain communication situations can be challenging due to individuals’ lack of skills and the interference of strong emotions. However, effective learning opportunities are rarely accessible. In this work, we conduct a human-centered study that uses language models to simulate bespoke communication training and provide just-in-time feedback to support the practice and learning of interpersonal effectiveness skills. We apply the interpersonal effectiveness framework from Dialectical Behavioral Therapy (DBT), DEAR MAN, which focuses on both conversational and emotional skills. We present IMBUE, an interactive training system that provides feedback 28% more similar to experts’ feedback, compared to that generated by GPT-4. IMBUE is the first to focus on communication skills and emotion management simultaneously, incorporate experts’ domain knowledge in providing feedback, and be grounded in psychology theory. Through a randomized trial of 86 participants, we find that IMBUE’s simulation-only variant significantly improves participants’ self-efficacy (up to 17%) and reduces negative emotions (up to 25%). With IMBUE’s additional just-in-time feedback, participants demonstrate 17% improvement in skill mastery, along with greater enhancements in self-efficacy (27% more) and reduction of negative emotions (16% more) compared to simulation-only. The improvement in skill mastery is the only measure that is transferred to new and more difficult situations; situation-specific training is necessary for improving self-efficacy and emotion reduction.

A proven therapeutic technique to overcome negative thoughts is to replace them with a more hopeful “reframed thought.” Although therapy can help people practice and learn this Cognitive Reframing of Negative Thoughts, clinician shortages and mental health stigma commonly limit people’s access to therapy. In this paper, we conduct a human-centered study of how language models may assist people in reframing negative thoughts. Based on psychology literature, we define a framework of seven linguistic attributes that can be used to reframe a thought. We develop automated metrics to measure these attributes and validate them with expert judgements from mental health practitioners. We collect a dataset of 600 situations, thoughts and reframes from practitioners and use it to train a retrieval-enhanced in-context learning model that effectively generates reframed thoughts and controls their linguistic attributes. To investigate what constitutes a “high-quality” reframe, we conduct an IRB-approved randomized field study on a large mental health website with over 2,000 participants. Amongst other findings, we show that people prefer highly empathic or specific reframes, as opposed to reframes that are overly positive. Our findings provide key implications for the use of LMs to assist people in overcoming negative thoughts.

Mental health stigma prevents many individuals from receiving the appropriate care, and social psychology studies have shown that mental health tends to be overlooked in men. In this work, we investigate gendered mental health stigma in masked language models. In doing so, we operationalize mental health stigma by developing a framework grounded in psychology research: we use clinical psychology literature to curate prompts, then evaluate the models’ propensity to generate gendered words. We find that masked language models capture societal stigma about gender in mental health: models are consistently more likely to predict female subjects than male in sentences about having a mental health condition (32% vs. 19%), and this disparity is exacerbated for sentences that indicate treatment-seeking behavior. Furthermore, we find that different models capture dimensions of stigma differently for men and women, associating stereotypes like anger, blame, and pity more with women with mental health conditions than with men. In showing the complex nuances of models’ gendered mental health stigma, we demonstrate that context and overlapping dimensions of identity are important considerations when assessing computational models’ social biases.

In recent years, remote digital healthcare using online chats has gained momentum, especially in the Global South. Though prior work has studied interaction patterns in online (health) forums, such as TalkLife, Reddit and Facebook, there has been limited work in understanding interactions in small, close-knit community of instant messengers. In this paper, we propose a linguistic annotation framework to facilitate analysis of health-focused WhatsApp groups. The primary aim of the framework is to understand interpersonal relationships among peer supporters in order to help develop NLP solutions for remote patient care and reduce burden of overworked healthcare providers. Our framework consists of fine-grained peer support categorization and message-level sentiment tagging. Additionally, due to the prevalence of code-mixing in such groups, we incorporate word-level language annotations. We use the proposed framework to study two WhatsApp groups in Kenya for youth living with HIV, facilitated by a healthcare provider.

Empathy is critical to successful mental health support. Empathy measurement has predominantly occurred in synchronous, face-to-face settings, and may not translate to asynchronous, text-based contexts. Because millions of people use text-based platforms for mental health support, understanding empathy in these contexts is crucial. In this work, we present a computational approach to understanding how empathy is expressed in online mental health platforms. We develop a novel unifying theoretically-grounded framework for characterizing the communication of empathy in text-based conversations. We collect and share a corpus of 10k (post, response) pairs annotated using this empathy framework with supporting evidence for annotations (rationales). We develop a multi-task RoBERTa-based bi-encoder model for identifying empathy in conversations and extracting rationales underlying its predictions. Experiments demonstrate that our approach can effectively identify empathic conversations. We further apply this model to analyze 235k mental health interactions and show that users do not self-learn empathy over time, revealing opportunities for empathy training and feedback.