CLFeb 23
TherapyGym: Evaluating and Aligning Clinical Fidelity and Safety in Therapy ChatbotsFangrui Huang, Souhad Chbeir, Arpandeep Khatua et al.
Large language models (LLMs) are increasingly used for mental-health support; yet prevailing evaluation methods--fluency metrics, preference tests, and generic dialogue benchmarks--fail to capture the clinically critical dimensions of psychotherapy. We introduce THERAPYGYM, a framework that evaluates and improves therapy chatbots along two clinical pillars: fidelity and safety. Fidelity is measured using the Cognitive Therapy Rating Scale (CTRS), implemented as an automated pipeline that scores adherence to CBT techniques over multi-turn sessions. Safety is assessed using a multi-label annotation scheme, covering therapy-specific risks (e.g., failing to address harm or abuse). To mitigate bias and unreliability in LLM-based judges, we further release THERAPYJUDGEBENCH, a validation set of 116 dialogues with 1,270 expert ratings for auditing and calibration against licensed clinicians. THERAPYGYM also serves as a training harness: CTRS and safety-based rewards drive RL with configurable patient simulations spanning diverse symptom profiles. Models trained in THERAPYGYM improve on expert ratings, with average CTRS rising from 0.10 to 0.60 (and 0.16 to 0.59 under LLM judges). Our work enables scalable development of therapy chatbots that are faithful to evidence-based practice and safer in high-stakes use.
78.7CVMay 19
NeuroQA: A Large-Scale Image-Grounded Benchmark for 3D Brain MRI UnderstandingMohammad H. Abbasi, Favour Nerrise, Shaurnav Ghosh et al.
We present NeuroQA, a large-scale benchmark for visual question answering in 3D brain magnetic resonance imaging (MRI), with 56,953 QA pairs from 12,977 subjects across 12 datasets. It spans ages 5-104 and five clinical domains: Alzheimer's, Parkinson's, tumors, white matter disease, and neurodevelopment. Unlike prior medical Visual Question Answering (VQA) efforts that operate on 2D slices or rely on narrow diagnostic labels, NeuroQA pairs every item with a full 3D volume. It evaluates 11 clinically grounded reasoning skills across Yes/No, multiple-choice, and open-ended formats. Of the 203 templates, 131 are image-grounded (answerable from a 3-plane viewer) and 72 are image-informed (ground truth from quantitative volumetry or clinical instruments). To remove text-only shortcuts, we apply answer-distribution refinement, reducing closed-format text-only accuracy from $>$80% to 44.6%; image necessity is assessed separately through an image-grounding protocol released with the benchmark. A 38-rule deterministic pipeline and two rounds of expert review verify every QA pair against FreeSurfer measurements, metadata, or radiology report fields, with zero same-subject contradictions across templates. We conduct a clinician evaluation in which two clinicians independently assess 100 frozen test items on a three-plane viewer. On closed-format (Yes/No + multiple-choice) test-public items, the best zero-shot vision-language model and a supervised 3D CNN baseline reach 47.5% and 43.7% accuracy respectively, both below the 49.4% text-only majority-template floor. NeuroQA adopts a two-tier release with public QA pairs for open-access datasets and reproducible generation scripts for datasets restricted by data use agreements (DUAs), plus subject-level splits, a held-out private test set, and an online leaderboard.