While AI-assisted text-based counseling is gaining attention, it remains empirically unclear which counselor behaviors are associated with higher dialogue quality. Existing research often focuses heavily on Reflection, borrowing frameworks from Motivational Interviewing. To address this gap, we conduct a multi-layered analysis using KokoroChat, a large-scale Japanese text counseling dataset conducted by professional counselors and trainees, newly annotated with counselor strategy tags and client distress levels. Our results show that, under the quality indicators used in this study, Affirmation is more consistently associated with session quality than Reflection among the analyzed strategies. Cross-dataset transfer experiments further suggest that this quality signal can be observed to some extent on ESConv, an English dataset with non-expert supporters. These findings provide empirical implications for counselor training and emotional support system design. We release the additional KokoroChat annotations and experimental source code at https://github.com/UEC-InabaLab/BeyondReflection.
Reasoning large language models (LLMs) have recently made much progress in complex problem-solving, leveraging internal reasoning (or thought) to guide their solution generation. However, existing LLM-based counseling agents, including those using Motivational Interviewing (MI), generate responses without explicitly aligning thoughts with counseling techniques, limiting their effectiveness. We propose MIThinker, a lightweight thinking model that generates therapeutic thoughts to guide MI counseling agents in strategy selection and response generation. To overcome the lack of annotated thought data, we introduce AugR1-MI, an automated pipeline that reverse-engineers counselor's thoughts from observed responses. Through two-stage training combining supervised fine-tuning and reinforcement learning, MIThinker demonstrates improved theory-of-mind assessment and strategy alignment. Comprehensive evaluations show that MindfulMI, our agent leveraging MIThinker, achieves MI competency comparable to state-of-the-art systems with an order of magnitude less computation.
Eliya Naomi Aharon, Meytal Grimland, Avi Segal +4cs.CL
Effective mental health counseling is a complex, theory-driven process requiring the simultaneous integration of psychological frameworks, real-time distress signals, and strategic intervention planning. This level of clinical reasoning is critical for safety and therapeutic effectiveness but is often missing in general-purpose Large Language Models (LLMs). We introduce SAGE (Strategy-Aware Graph-Enhanced), a novel framework designed to bridge the gap between structured clinical knowledge and generative AI. SAGE constructs a heterogeneous graph that unifies conversational dynamics with a psychologically grounded layer, explicitly anchoring interactions in a theory-driven lexicon. Our architecture first employs a Next Strategy Classifier to identify the optimal therapeutic intervention. Subsequently, a Graph-Aware Attention mechanism projects graph-derived structural signals into soft prompts, conditioning the LLM to generate responses that maintain clinical depth. Validated through both automated metrics and expert human evaluation, SAGE outperforms baselines in strategy prediction and recommended response quality. By providing actionable intervention recommendations, SAGE serves as a cutting-edge decision-support tool designed to augment human expertise in high-stakes crisis counseling.