Robert E. Kraut

Raj Sanjay Shah, Faye Holt, Shirley Anugrah Hayati et al.

Millions of people participate in online peer-to-peer support sessions, yet there has been little prior research on systematic psychology-based evaluations of fine-grained peer-counselor behavior in relation to client satisfaction. This paper seeks to bridge this gap by mapping peer-counselor chat-messages to motivational interviewing (MI) techniques. We annotate 14,797 utterances from 734 chat conversations using 17 MI techniques and introduce four new interviewing codes such as chit-chat and inappropriate to account for the unique conversational patterns observed on online platforms. We automate the process of labeling peer-counselor responses to MI techniques by fine-tuning large domain-specific language models and then use these automated measures to investigate the behavior of the peer counselors via correlational studies. Specifically, we study the impact of MI techniques on the conversation ratings to investigate the techniques that predict clients' satisfaction with their counseling sessions. When counselors use techniques such as reflection and affirmation, clients are more satisfied. Examining volunteer counselors' change in usage of techniques suggest that counselors learn to use more introduction and open questions as they gain experience. This work provides a deeper understanding of the use of motivational interviewing techniques on peer-to-peer counselor platforms and sheds light on how to build better training programs for volunteer counselors on online platforms.

Yutong Zhang, Dora Zhao, Jeffrey T. Hancock et al.

As large language model (LLM)-enhanced chatbots become increasingly expressive and socially responsive, many users begin forming companionship-like bonds with them. This study investigates how using AI companions relates to psychological well-being. We collected self-reported data from 1,131 U.S. adults who use CharacterAI, including survey responses and 4,664 chat sessions (464,687 messages) from 237 participants. By triangulating self-reported usage, relationship descriptions, and real chat histories, we identify patterns of engagement and associated outcomes. Smaller social networks were associated with reporting companionship as the primary chatbot use (beta = -0.03, 95% confidence interval (CI) [-0.05, -0.01]), which in turn was associated with lower well-being (beta = -0.48, 95% CI [-0.70, -0.25]). For self-reported companionship usage, this association was stronger when interactions were intensive (beta = -0.31, 95% CI [-0.56, -0.06]) and highly disclosive (beta = -0.38, 95% CI [-0.63, -0.14]). These results suggest that the association between AI companionship and well-being is not uniform and depends on how chatbots are used and users' offline social environments.

Yuhan Liu, Anna Fang, Glen Moriarty et al.

Online mental health communities (OMHCs) are an effective and accessible channel to give and receive social support for individuals with mental and emotional issues. However, a key challenge on these platforms is finding suitable partners to interact with given that mechanisms to match users are currently underdeveloped. In this paper, we collaborate with one of the world's largest OMHC to develop an agent-based simulation framework and explore the trade-offs in different matching algorithms. The simulation framework allows us to compare current mechanisms and new algorithmic matching policies on the platform, and observe their differing effects on a variety of outcome metrics. Our findings include that usage of the deferred-acceptance algorithm can significantly better the experiences of support-seekers in one-on-one chats while maintaining low waiting time. We note key design considerations that agent-based modeling reveals in the OMHC context, including the potential benefits of algorithmic matching on marginalized communities.

Alicja Chaszczewicz, Raj Sanjay Shah, Ryan Louie et al.

Realistic practice and tailored feedback are key processes for training peer counselors with clinical skills. However, existing mechanisms of providing feedback largely rely on human supervision. Peer counselors often lack mechanisms to receive detailed feedback from experienced mentors, making it difficult for them to support the large number of people with mental health issues who use peer counseling. Our work aims to leverage large language models to provide contextualized and multi-level feedback to empower peer counselors, especially novices, at scale. To achieve this, we co-design with a group of senior psychotherapy supervisors to develop a multi-level feedback taxonomy, and then construct a publicly available dataset with comprehensive feedback annotations of 400 emotional support conversations. We further design a self-improvement method on top of large language models to enhance the automatic generation of feedback. Via qualitative and quantitative evaluation with domain experts, we demonstrate that our method minimizes the risk of potentially harmful and low-quality feedback generation which is desirable in such high-stakes scenarios.

Keyeun Lee, Seolhee Lee, Esther Hehsun Kim et al.

Effective communication training is essential to preparing nurses for high-quality patient care. While standardized patient (SP) simulations provide valuable experiential learning, they are often costly and inflexible. Virtual patient (VP) systems offer a scalable alternative, but most fail to adapt to the varying communication skills of trainees. In particular, when trainees respond ineffectively, VPs should escalate in hostility or become uncooperative--yet this level of adaptive interaction remains largely unsupported. To address this gap, we introduce Adaptive-VP, a VP dialogue generation framework that leverages large language models (LLMs) to dynamically adapt VP behavior based on trainee input. The framework features a pipeline for constructing clinically grounded yet flexible VP scenarios and a modular system for assessing trainee communication and adjusting VP responses in real time, while ensuring learner safety. We validated Adaptive-VP by simulating challenging patient conversations. Automated evaluation using a corpus from practicing nurses showed that our communication skill evaluation mechanism reflected real-world proficiency levels. Expert nurses further confirmed that Adaptive-VP produced more natural and realistic interactions than existing approaches, demonstrating its potential as a scalable and effective tool for nursing communication training.

Yi-Chia Wang, Alexandros Papangelis, Runze Wang et al.

Goal-oriented conversational agents are becoming prevalent in our daily lives. For these systems to engage users and achieve their goals, they need to exhibit appropriate social behavior as well as provide informative replies that guide users through tasks. The first component of the research in this paper applies statistical modeling techniques to understand conversations between users and human agents for customer service. Analyses show that social language used by human agents is associated with greater users' responsiveness and task completion. The second component of the research is the construction of a conversational agent model capable of injecting social language into an agent's responses while still preserving content. The model uses a sequence-to-sequence deep learning architecture, extended with a social language understanding element. Evaluation in terms of content preservation and social language level using both human judgment and automatic linguistic measures shows that the model can generate responses that enable agents to address users' issues in a more socially appropriate way.