In Motivational Interviewing (MI), a client's sustain talk (arguments for the status quo) calls for the counselor to roll with resistance, a move that can fail in two opposite ways: capitulation (abandoning the change agenda to preserve rapport) or confrontation (arguing or directing, overriding the client's autonomy). We introduce a two-axis evaluation of counselor responses, anchored in the Motivational Interviewing Treatment Integrity (MITI) code, Goal Persistence (GP) and Relational Attunement (RA), yielding a four-quadrant framing in which rolling with resistance is high on both, and we ask whether penalizing one failure through preference optimization teaches rolling with resistance or provokes its opposite. From the expert-annotated AnnoMI corpus we build topic-disjoint Direct Preference Optimization data whose preference sets differ only in which failure is rejected, using on-policy negatives. An automatic judge, validated against AnnoMI's expert labels and rechecked by trained human coders, scores blind pairwise win-rates against each base under a firewall in which disjoint model families generate, label, and judge. Across three aligned instruction models spanning the Qwen and Llama families, penalizing confrontation reliably lowers goal persistence below parity, on every base and in every seed run, a robust cost, whereas the attunement gain is base-dependent, present on two of the three bases but absent on the third. Penalizing capitulation is inert, because these models rarely capitulate on-policy, so the trade is gated by each base's failure profile. A prompt-only control raises attunement without the goal-persistence cost, locating the cost in the optimization rather than in attunement itself.
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.
Jiading Zhu, Xinyu Cindy Wang, Thomas Nguyen +4cs.HC cs.AI cs.CL
The development and benchmarking of Large Language Model (LLM)-based Motivational Interviewing (MI) counsellors now often rely on LLM-based simulated clients. Prior work on simulated clients, however, has not aligned with the specific tasks fundamental to the MI therapy approach. A key task is evoking, in which the counsellor first elicits the client's ambivalence and then strengthens the client's motivation for change. We present Evoke-Sim, a task-aware, multi-stage LLM-based client simulation framework for evaluating MI counsellors in smoking cessation, designed specifically for the evoking MI task. Evoke-Sim employs structured client profiles, an evoking-specific three-stage conversation flow, and a reveal policy that regulates which client profile information might be disclosed at each stage. We show that compared to existing profile-grounded simulated clients, Evoke-Sim is better at differentiating levels of MI quality using task-aware evaluation metrics, while reducing non-grounded client statements and premature disclosure of client information, setting a higher standard for the evaluation of LLM-based MI counsellors.