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routineHealthcare & BiomedicalLLM2608.07499

Evaluation of Motivational Interviewing Counsellors with Task-Aware Multi-Stage LLM-Based Simulated Clients

Jiading Zhu, Xinyu Cindy Wang, Thomas Nguyen, Yan Qing Lee, Osnat C. Melamed, Peter Selby, Jonathan Rose

cs.HC cs.AI cs.CL

Abstract

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.

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Classified with taxonomy v2 on Sat, 5 Sept 2026.

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