Daily Papers

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

The latest large language models (LLMs) such as ChatGPT, exhibit strong capabilities in automated mental health analysis. However, existing relevant studies bear several limitations, including inadequate evaluations, lack of prompting strategies, and ignorance of exploring LLMs for explainability. To bridge these gaps, we comprehensively evaluate the mental health analysis and emotional reasoning ability of LLMs on 11 datasets across 5 tasks. We explore the effects of different prompting strategies with unsupervised and distantly supervised emotional information. Based on these prompts, we explore LLMs for interpretable mental health analysis by instructing them to generate explanations for each of their decisions. We convey strict human evaluations to assess the quality of the generated explanations, leading to a novel dataset with 163 human-assessed explanations. We benchmark existing automatic evaluation metrics on this dataset to guide future related works. According to the results, ChatGPT shows strong in-context learning ability but still has a significant gap with advanced task-specific methods. Careful prompt engineering with emotional cues and expert-written few-shot examples can also effectively improve performance on mental health analysis. In addition, ChatGPT generates explanations that approach human performance, showing its great potential in explainable mental health analysis.

The deployment of large language models (LLMs) in mental health and other sensitive domains raises urgent questions about ethical reasoning, fairness, and responsible alignment. Yet, existing benchmarks for moral and clinical decision-making do not adequately capture the unique ethical dilemmas encountered in mental health practice, where confidentiality, autonomy, beneficence, and bias frequently intersect. To address this gap, we introduce Ethical Reasoning in Mental Health (EthicsMH), a pilot dataset of 125 scenarios designed to evaluate how AI systems navigate ethically charged situations in therapeutic and psychiatric contexts. Each scenario is enriched with structured fields, including multiple decision options, expert-aligned reasoning, expected model behavior, real-world impact, and multi-stakeholder viewpoints. This structure enables evaluation not only of decision accuracy but also of explanation quality and alignment with professional norms. Although modest in scale and developed with model-assisted generation, EthicsMH establishes a task framework that bridges AI ethics and mental health decision-making. By releasing this dataset, we aim to provide a seed resource that can be expanded through community and expert contributions, fostering the development of AI systems capable of responsibly handling some of society's most delicate decisions.

Mental health remains a challenging problem all over the world, with issues like depression, anxiety becoming increasingly common. Large Language Models (LLMs) have seen a vast application in healthcare, specifically in answering medical questions. However, there is a lack of standard benchmarking datasets for question answering (QA) in mental health. Our work presents a novel multiple choice dataset, MHQA (Mental Health Question Answering), for benchmarking Language models (LMs). Previous mental health datasets have focused primarily on text classification into specific labels or disorders. MHQA, on the other hand, presents question-answering for mental health focused on four key domains: anxiety, depression, trauma, and obsessive/compulsive issues, with diverse question types, namely, factoid, diagnostic, prognostic, and preventive. We use PubMed abstracts as the primary source for QA. We develop a rigorous pipeline for LLM-based identification of information from abstracts based on various selection criteria and converting it into QA pairs. Further, valid QA pairs are extracted based on post-hoc validation criteria. Overall, our MHQA dataset consists of 2,475 expert-verified gold standard instances called MHQA-gold and ~56.1k pairs pseudo labeled using external medical references. We report F1 scores on different LLMs along with few-shot and supervised fine-tuning experiments, further discussing the insights for the scores.

The Mental Health Question Answer (MHQA) task requires the seeker and supporter to complete the support process in one-turn dialogue. Given the richness of help-seeker posts, supporters must thoroughly understand the content and provide logical, comprehensive, and well-structured responses. Previous works in MHQA mostly focus on single-agent approaches based on the cognitive element of Cognitive Behavioral Therapy (CBT), but they overlook the interactions among various CBT elements, such as emotion and cognition. This limitation hinders the models' ability to thoroughly understand the distress of help-seekers. To address this, we propose a framework named Multi-Agent Deductive Planning (MADP), which is based on the interactions between the various psychological elements of CBT. This method guides Large Language Models (LLMs) to achieve a deeper understanding of the seeker's context and provide more personalized assistance based on individual circumstances. Furthermore, we construct a new dataset based on the MADP framework and use it to fine-tune LLMs, resulting in a specialized model named MADP-LLM. We conduct extensive experiments, including comparisons with multiple LLMs, human evaluations, and automatic evaluations, to validate the effectiveness of the MADP framework and MADP-LLM.

Global rates of mental health concerns are rising and there is increasing realization that existing models of mental healthcare will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health-related tasks. In this review, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs application to mental health and encourage adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. Especially critical is ensuring that mental health LLMs are fine-tuned for mental health, enhance mental health equity, adhere to ethical standards, and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.

Users of social platforms often perceive these sites as supportive spaces to post about their mental health issues. Those conversations contain important traces about individuals' health risks. Recently, researchers have exploited this online information to construct mental health detection models, which aim to identify users at risk on platforms like Twitter, Reddit or Facebook. Most of these models are centred on achieving good classification results, ignoring the explainability and interpretability of the decisions. Recent research has pointed out the importance of using clinical markers, such as the use of symptoms, to improve trust in the computational models by health professionals. In this paper, we propose using transformer-based architectures to detect and explain the appearance of depressive symptom markers in the users' writings. We present two approaches: i) train a model to classify, and another one to explain the classifier's decision separately and ii) unify the two tasks simultaneously using a single model. Additionally, for this latter manner, we also investigated the performance of recent conversational LLMs when using in-context learning. Our natural language explanations enable clinicians to interpret the models' decisions based on validated symptoms, enhancing trust in the automated process. We evaluate our approach using recent symptom-based datasets, employing both offline and expert-in-the-loop metrics to assess the quality of the explanations generated by our models. The experimental results show that it is possible to achieve good classification results while generating interpretable symptom-based explanations.

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

As mental health issues globally escalate, there is a tremendous need for advanced digital support systems. We introduce MentalAgora, a novel framework employing large language models enhanced by interaction between multiple agents for tailored mental health support. This framework operates through three stages: strategic debating, tailored counselor creation, and response generation, enabling the dynamic customization of responses based on individual user preferences and therapeutic needs. We conduct experiments utilizing a high-quality evaluation dataset TherapyTalk crafted with mental health professionals, shwoing that MentalAgora generates expert-aligned and user preference-enhanced responses. Our evaluations, including experiments and user studies, demonstrate that MentalAgora aligns with professional standards and effectively meets user preferences, setting a new benchmark for digital mental health interventions.

Student mental health is a sensitive issue that necessitates special attention. A primary concern is the student-to-counselor ratio, which surpasses the recommended standard of 250:1 in most universities. This imbalance results in extended waiting periods for in-person consultations, which cause suboptimal treatment. Significant efforts have been directed toward developing mental health dialogue systems utilizing the existing open-source mental health-related datasets. However, currently available datasets either discuss general topics or various strategies that may not be viable for direct application due to numerous ethical constraints inherent in this research domain. To address this issue, this paper introduces a specialized mental health dataset that emphasizes the active listening strategy employed in conversation for counseling, also named as ConvCounsel. This dataset comprises both speech and text data, which can facilitate the development of a reliable pipeline for mental health dialogue systems. To demonstrate the utility of the proposed dataset, this paper also presents the NYCUKA, a spoken mental health dialogue system that is designed by using the ConvCounsel dataset. The results show the merit of using this dataset.

Amidst a shortage of qualified mental health professionals, the integration of large language models (LLMs) into psychological applications offers a promising way to alleviate the growing burden of mental health disorders. Recent reasoning-augmented LLMs have achieved remarkable performance in mathematics and programming, while research in the psychological domain has predominantly emphasized emotional support and empathetic dialogue, with limited attention to reasoning mechanisms that are beneficial to generating reliable responses. Therefore, in this paper, we propose Psyche-R1, the first Chinese psychological LLM that jointly integrates empathy, psychological expertise, and reasoning, built upon a novel data curation pipeline. Specifically, we design a comprehensive data synthesis pipeline that produces over 75k high-quality psychological questions paired with detailed rationales, generated through chain-of-thought (CoT) reasoning and iterative prompt-rationale optimization, along with 73k empathetic dialogues. Subsequently, we employ a hybrid training strategy wherein challenging samples are identified through a multi-LLM cross-selection strategy for group relative policy optimization (GRPO) to improve reasoning ability, while the remaining data is used for supervised fine-tuning (SFT) to enhance empathetic response generation and psychological domain knowledge. Extensive experiment results demonstrate the effectiveness of the Psyche-R1 across several psychological benchmarks, where our 7B Psyche-R1 achieves comparable results to 671B DeepSeek-R1.

Mental health risk is a critical global public health challenge, necessitating innovative and reliable assessment methods. With the development of large language models (LLMs), they stand out to be a promising tool for explainable mental health care applications. Nevertheless, existing approaches predominantly rely on subjective textual mental records, which can be distorted by inherent mental uncertainties, leading to inconsistent and unreliable predictions. To address these limitations, this paper introduces ProMind-LLM. We investigate an innovative approach integrating objective behavior data as complementary information alongside subjective mental records for robust mental health risk assessment. Specifically, ProMind-LLM incorporates a comprehensive pipeline that includes domain-specific pretraining to tailor the LLM for mental health contexts, a self-refine mechanism to optimize the processing of numerical behavioral data, and causal chain-of-thought reasoning to enhance the reliability and interpretability of its predictions. Evaluations of two real-world datasets, PMData and Globem, demonstrate the effectiveness of our proposed methods, achieving substantial improvements over general LLMs. We anticipate that ProMind-LLM will pave the way for more dependable, interpretable, and scalable mental health case solutions.

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

Mental health is a critical issue in modern society, and mental disorders could sometimes turn to suicidal ideation without adequate treatment. Early detection of mental disorders and suicidal ideation from social content provides a potential way for effective social intervention. Recent advances in pretrained contextualized language representations have promoted the development of several domain-specific pretrained models and facilitated several downstream applications. However, there are no existing pretrained language models for mental healthcare. This paper trains and release two pretrained masked language models, i.e., MentalBERT and MentalRoBERTa, to benefit machine learning for the mental healthcare research community. Besides, we evaluate our trained domain-specific models and several variants of pretrained language models on several mental disorder detection benchmarks and demonstrate that language representations pretrained in the target domain improve the performance of mental health detection tasks.

People often utilise online media (e.g., Facebook, Reddit) as a platform to express their psychological distress and seek support. State-of-the-art NLP techniques demonstrate strong potential to automatically detect mental health issues from text. Research suggests that mental health issues are reflected in emotions (e.g., sadness) indicated in a person's choice of language. Therefore, we developed a novel emotion-annotated mental health corpus (EmoMent), consisting of 2802 Facebook posts (14845 sentences) extracted from two South Asian countries - Sri Lanka and India. Three clinical psychology postgraduates were involved in annotating these posts into eight categories, including 'mental illness' (e.g., depression) and emotions (e.g., 'sadness', 'anger'). EmoMent corpus achieved 'very good' inter-annotator agreement of 98.3% (i.e. % with two or more agreement) and Fleiss' Kappa of 0.82. Our RoBERTa based models achieved an F1 score of 0.76 and a macro-averaged F1 score of 0.77 for the first task (i.e. predicting a mental health condition from a post) and the second task (i.e. extent of association of relevant posts with the categories defined in our taxonomy), respectively.

The limited availability of psychologists necessitates efficient identification of individuals requiring urgent mental healthcare. This study explores the use of Natural Language Processing (NLP) pipelines to analyze text data from online mental health forums used for consultations. By analyzing forum posts, these pipelines can flag users who may require immediate professional attention. A crucial challenge in this domain is data privacy and scarcity. To address this, we propose utilizing readily available curricular texts used in institutes specializing in mental health for pre-training the NLP pipelines. This helps us mimic the training process of a psychologist. Our work presents CASE-BERT that flags potential mental health disorders based on forum text. CASE-BERT demonstrates superior performance compared to existing methods, achieving an f1 score of 0.91 for Depression and 0.88 for Anxiety, two of the most commonly reported mental health disorders. Our code is publicly available.

As mental health care systems worldwide struggle to meet demand, there is increasing focus on using language models to infer neuropsychiatric conditions or psychopathological traits from language production. Yet, so far, this research has only delivered solutions with limited clinical applicability, due to insufficient consideration of ethical questions crucial to ensuring the synergy between possible applications and model design. To accelerate progress towards clinically applicable models, our paper charts the ethical landscape of research on language-based inference of psychopathology and provides a practical tool for researchers to navigate it. We identify seven core ethical principles that should guide model development and deployment in this domain, translate them into ELLIPS, an ethical toolkit operationalizing these principles into questions that can guide researchers' choices with respect to data selection, architectures, evaluation, and model deployment, and provide a case study exemplifying its use. With this, we aim to facilitate the emergence of model technology with concrete potential for real-world applicability.

Passively collected behavioral health data from ubiquitous sensors holds significant promise to provide mental health professionals insights from patient's daily lives; however, developing analysis tools to use this data in clinical practice requires addressing challenges of generalization across devices and weak or ambiguous correlations between the measured signals and an individual's mental health. To address these challenges, we take a novel approach that leverages large language models (LLMs) to synthesize clinically useful insights from multi-sensor data. We develop chain of thought prompting methods that use LLMs to generate reasoning about how trends in data such as step count and sleep relate to conditions like depression and anxiety. We first demonstrate binary depression classification with LLMs achieving accuracies of 61.1% which exceed the state of the art. While it is not robust for clinical use, this leads us to our key finding: even more impactful and valued than classification is a new human-AI collaboration approach in which clinician experts interactively query these tools and combine their domain expertise and context about the patient with AI generated reasoning to support clinical decision-making. We find models like GPT-4 correctly reference numerical data 75% of the time, and clinician participants express strong interest in using this approach to interpret self-tracking data.

With the development of web technology, social media texts are becoming a rich source for automatic mental health analysis. As traditional discriminative methods bear the problem of low interpretability, the recent large language models have been explored for interpretable mental health analysis on social media, which aims to provide detailed explanations along with predictions. The results show that ChatGPT can generate approaching-human explanations for its correct classifications. However, LLMs still achieve unsatisfactory classification performance in a zero-shot/few-shot manner. Domain-specific finetuning is an effective solution, but faces 2 challenges: 1) lack of high-quality training data. 2) no open-source LLMs for interpretable mental health analysis were released to lower the finetuning cost. To alleviate these problems, we build the first multi-task and multi-source interpretable mental health instruction (IMHI) dataset on social media, with 105K data samples. The raw social media data are collected from 10 existing sources covering 8 mental health analysis tasks. We use expert-written few-shot prompts and collected labels to prompt ChatGPT and obtain explanations from its responses. To ensure the reliability of the explanations, we perform strict automatic and human evaluations on the correctness, consistency, and quality of generated data. Based on the IMHI dataset and LLaMA2 foundation models, we train MentalLLaMA, the first open-source LLM series for interpretable mental health analysis with instruction-following capability. We also evaluate the performance of MentalLLaMA on the IMHI evaluation benchmark with 10 test sets, where their correctness for making predictions and the quality of explanations are examined. The results show that MentalLLaMA approaches state-of-the-art discriminative methods in correctness and generates high-quality explanations.

Limited access to mental healthcare, extended wait times, and increasing capabilities of Large Language Models (LLMs) has led individuals to turn to LLMs for fulfilling their mental health needs. However, examining the multi-turn mental health conversation capabilities of LLMs remains under-explored. Existing evaluation frameworks typically focus on diagnostic accuracy and win-rates and often overlook alignment with patient-specific goals, values, and personalities required for meaningful conversations. To address this, we introduce MedAgent, a novel framework for synthetically generating realistic, multi-turn mental health sensemaking conversations and use it to create the Mental Health Sensemaking Dialogue (MHSD) dataset, comprising over 2,200 patient-LLM conversations. Additionally, we present MultiSenseEval, a holistic framework to evaluate the multi-turn conversation abilities of LLMs in healthcare settings using human-centric criteria. Our findings reveal that frontier reasoning models yield below-par performance for patient-centric communication and struggle at advanced diagnostic capabilities with average score of 31%. Additionally, we observed variation in model performance based on patient's persona and performance drop with increasing turns in the conversation. Our work provides a comprehensive synthetic data generation framework, a dataset and evaluation framework for assessing LLMs in multi-turn mental health conversations.

Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.

Mental health is a significant and growing public health concern. As language usage can be leveraged to obtain crucial insights into mental health conditions, there is a need for large-scale, labeled, mental health-related datasets of users who have been diagnosed with one or more of such conditions. In this paper, we investigate the creation of high-precision patterns to identify self-reported diagnoses of nine different mental health conditions, and obtain high-quality labeled data without the need for manual labelling. We introduce the SMHD (Self-reported Mental Health Diagnoses) dataset and make it available. SMHD is a novel large dataset of social media posts from users with one or multiple mental health conditions along with matched control users. We examine distinctions in users' language, as measured by linguistic and psychological variables. We further explore text classification methods to identify individuals with mental conditions through their language.

Language Models (LMs) are being proposed for mental health applications where the heightened risk of adverse outcomes means predictive performance may not be a sufficient litmus test of a model's utility in clinical practice. A model that can be trusted for practice should have a correspondence between explanation and clinical determination, yet no prior research has examined the attention fidelity of these models and their effect on ground truth explanations. We introduce an evaluation design that focuses on the robustness and explainability of LMs in identifying Wellness Dimensions (WDs). We focus on two existing mental health and well-being datasets: (a) Multi-label Classification-based MultiWD, and (b) WellXplain for evaluating attention mechanism veracity against expert-labeled explanations. The labels are based on Halbert Dunn's theory of wellness, which gives grounding to our evaluation. We reveal four surprising results about LMs/LLMs: (1) Despite their human-like capabilities, GPT-3.5/4 lag behind RoBERTa, and MedAlpaca, a fine-tuned LLM on WellXplain fails to deliver any remarkable improvements in performance or explanations. (2) Re-examining LMs' predictions based on a confidence-oriented loss function reveals a significant performance drop. (3) Across all LMs/LLMs, the alignment between attention and explanations remains low, with LLMs scoring a dismal 0.0. (4) Most mental health-specific LMs/LLMs overlook domain-specific knowledge and undervalue explanations, causing these discrepancies. This study highlights the need for further research into their consistency and explanations in mental health and well-being.

The increasing prevalence of mental health disorders globally highlights the urgent need for effective digital screening methods that can be used in multilingual contexts. Most existing studies, however, focus on English data, overlooking critical mental health signals that may be present in non-English texts. To address this important gap, we present the first survey on the detection of mental health disorders using multilingual social media data. We investigate the cultural nuances that influence online language patterns and self-disclosure behaviors, and how these factors can impact the performance of NLP tools. Additionally, we provide a comprehensive list of multilingual data collections that can be used for developing NLP models for mental health screening. Our findings can inform the design of effective multilingual mental health screening tools that can meet the needs of diverse populations, ultimately improving mental health outcomes on a global scale.

As the prevalence of mental health challenges, social media has emerged as a key platform for individuals to express their emotions.Deep learning tends to be a promising solution for analyzing mental health on social media. However, black box models are often inflexible when switching between tasks, and their results typically lack explanations. With the rise of large language models (LLMs), their flexibility has introduced new approaches to the field. Also due to the generative nature, they can be prompted to explain decision-making processes. However, their performance on complex psychological analysis still lags behind deep learning. In this paper, we introduce the first multi-task Chinese Social Media Interpretable Mental Health Instructions (C-IMHI) dataset, consisting of 9K samples, which has been quality-controlled and manually validated. We also propose MentalGLM series models, the first open-source LLMs designed for explainable mental health analysis targeting Chinese social media, trained on a corpus of 50K instructions. The proposed models were evaluated on three downstream tasks and achieved better or comparable performance compared to deep learning models, generalized LLMs, and task fine-tuned LLMs. We validated a portion of the generated decision explanations with experts, showing promising results. We also evaluated the proposed models on a clinical dataset, where they outperformed other LLMs, indicating their potential applicability in the clinical field. Our models show strong performance, validated across tasks and perspectives. The decision explanations enhance usability and facilitate better understanding and practical application of the models. Both the constructed dataset and the models are publicly available via: https://github.com/zwzzzQAQ/MentalGLM.

Mental health is a critical issue in modern society, and mental disorders could sometimes turn to suicidal ideation without effective treatment. Early detection of mental disorders and suicidal ideation from social content provides a potential way for effective social intervention. However, classifying suicidal ideation and other mental disorders is challenging as they share similar patterns in language usage and sentimental polarity. This paper enhances text representation with lexicon-based sentiment scores and latent topics and proposes using relation networks to detect suicidal ideation and mental disorders with related risk indicators. The relation module is further equipped with the attention mechanism to prioritize more critical relational features. Through experiments on three real-world datasets, our model outperforms most of its counterparts.

Online mental health support communities have grown in recent years for providing accessible mental and emotional health support through volunteer counselors. Despite millions of people participating in chat support on these platforms, the clinical effectiveness of these communities on mental health symptoms remains unknown. Furthermore, although volunteers receive some training based on established therapeutic skills studied in face-to-face environments such as active listening and motivational interviewing, it remains understudied how the usage of these skills in this online context affects people's mental health status. In our work, we collaborate with one of the largest online peer support platforms and use both natural language processing and machine learning techniques to measure how one-on-one support chats affect depression and anxiety symptoms. We measure how the techniques and characteristics of support providers, such as using affirmation, empathy, and past experience on the platform, affect support-seekers' mental health changes. We find that online peer support chats improve both depression and anxiety symptoms with a statistically significant but relatively small effect size. Additionally, support providers' techniques such as emphasizing the autonomy of the client lead to better mental health outcomes. However, we also found that some behaviors (e.g. persuading) are actually harmful to depression and anxiety outcomes. Our work provides key understanding for mental health care in the online setting and designing training systems for online support providers.

Large Language Models (LLMs) in mental healthcare risk propagating biases that reinforce stigma and harm marginalized groups. While previous research identified concerning trends, systematic methods for detecting intersectional biases remain limited. This work introduces a multi-hop question answering (MHQA) framework to explore LLM response biases in mental health discourse. We analyze content from the Interpretable Mental Health Instruction (IMHI) dataset across symptom presentation, coping mechanisms, and treatment approaches. Using systematic tagging across age, race, gender, and socioeconomic status, we investigate bias patterns at demographic intersections. We evaluate four LLMs: Claude 3.5 Sonnet, Jamba 1.6, Gemma 3, and Llama 4, revealing systematic disparities across sentiment, demographics, and mental health conditions. Our MHQA approach demonstrates superior detection compared to conventional methods, identifying amplification points where biases magnify through sequential reasoning. We implement two debiasing techniques: Roleplay Simulation and Explicit Bias Reduction, achieving 66-94% bias reductions through few-shot prompting with BBQ dataset examples. These findings highlight critical areas where LLMs reproduce mental healthcare biases, providing actionable insights for equitable AI development.

Demand for mental health support through AI chatbots is surging, though current systems present several limitations, like sycophancy or overvalidation, and reinforcement of maladaptive beliefs. A core obstacle to the creation of better systems is the scarcity of benchmarks that capture the complexity of real therapeutic interactions. Most existing benchmarks either only test clinical knowledge through multiple-choice questions or assess single responses in isolation. To bridge this gap, we present MindEval, a framework designed in collaboration with Ph.D-level Licensed Clinical Psychologists for automatically evaluating language models in realistic, multi-turn mental health therapy conversations. Through patient simulation and automatic evaluation with LLMs, our framework balances resistance to gaming with reproducibility via its fully automated, model-agnostic design. We begin by quantitatively validating the realism of our simulated patients against human-generated text and by demonstrating strong correlations between automatic and human expert judgments. Then, we evaluate 12 state-of-the-art LLMs and show that all models struggle, scoring below 4 out of 6, on average, with particular weaknesses in problematic AI-specific patterns of communication. Notably, reasoning capabilities and model scale do not guarantee better performance, and systems deteriorate with longer interactions or when supporting patients with severe symptoms. We release all code, prompts, and human evaluation data.

In most current research, large language models (LLMs) are able to perform reasoning tasks by generating chains of thought through the guidance of specific prompts. However, there still exists a significant discrepancy between their capability in solving complex reasoning problems and that of humans. At present, most approaches focus on chains of thought (COT) and tool use, without considering the adoption and application of human cognitive frameworks. It is well-known that when confronting complex reasoning challenges, humans typically employ various cognitive abilities, and necessitate interaction with all aspects of tools, knowledge, and the external environment information to accomplish intricate tasks. This paper introduces a novel intelligent framework, referred to as OlaGPT. OlaGPT carefully studied a cognitive architecture framework, and propose to simulate certain aspects of human cognition. The framework involves approximating different cognitive modules, including attention, memory, reasoning, learning, and corresponding scheduling and decision-making mechanisms. Inspired by the active learning mechanism of human beings, it proposes a learning unit to record previous mistakes and expert opinions, and dynamically refer to them to strengthen their ability to solve similar problems. The paper also outlines common effective reasoning frameworks for human problem-solving and designs Chain-of-Thought (COT) templates accordingly. A comprehensive decision-making mechanism is also proposed to maximize model accuracy. The efficacy of OlaGPT has been stringently evaluated on multiple reasoning datasets, and the experimental outcomes reveal that OlaGPT surpasses state-of-the-art benchmarks, demonstrating its superior performance. Our implementation of OlaGPT is available on GitHub: https://github.com/oladata-team/OlaGPT.

Artificial Intelligence (AI) is a broad field that is upturning mental health care in many ways, from addressing anxiety, depression, and stress to increasing access, personalization of treatment, and real-time monitoring that enhances patient outcomes. The current paper discusses the evolution, present application, and future challenges in the field of AI for mental health and well-being. From the early chatbot models, such as ELIZA, to modern machine learning systems, the integration of AI in mental health has grown rapidly to augment traditional treatment and open innovative solutions. AI-driven tools provide continuous support, offering personalized interventions and addressing issues such as treatment access and patient stigma. AI also enables early diagnosis through the analysis of complex datasets, including speech patterns and social media behavior, to detect early signs of conditions like depression and Post-Traumatic Stress Disorder (PTSD). Ethical challenges persist, however, most notably around privacy, data security, and algorithmic bias. With AI at the core of mental health care, there is a dire need to develop strong ethical frameworks that ensure patient rights are protected, access is equitable, and transparency is maintained in AI applications. Going forward, the role of AI in mental health will continue to evolve, and continued research and policy development will be needed to meet the diverse needs of patients while mitigating associated risks.

Human-like personality traits have recently been discovered in large language models, raising the hypothesis that their (known and as yet undiscovered) biases conform with human latent psychological constructs. While large conversational models may be tricked into answering psychometric questionnaires, the latent psychological constructs of thousands of simpler transformers, trained for other tasks, cannot be assessed because appropriate psychometric methods are currently lacking. Here, we show how standard psychological questionnaires can be reformulated into natural language inference prompts, and we provide a code library to support the psychometric assessment of arbitrary models. We demonstrate, using a sample of 88 publicly available models, the existence of human-like mental health-related constructs (including anxiety, depression, and Sense of Coherence) which conform with standard theories in human psychology and show similar correlations and mitigation strategies. The ability to interpret and rectify the performance of language models by using psychological tools can boost the development of more explainable, controllable, and trustworthy models.

There is a significant gap between patient needs and available mental health support today. In this paper, we aim to thoroughly examine the potential of using Large Language Models (LLMs) to assist professional psychotherapy. To this end, we propose a new benchmark, CBT-BENCH, for the systematic evaluation of cognitive behavioral therapy (CBT) assistance. We include three levels of tasks in CBT-BENCH: I: Basic CBT knowledge acquisition, with the task of multiple-choice questions; II: Cognitive model understanding, with the tasks of cognitive distortion classification, primary core belief classification, and fine-grained core belief classification; III: Therapeutic response generation, with the task of generating responses to patient speech in CBT therapy sessions. These tasks encompass key aspects of CBT that could potentially be enhanced through AI assistance, while also outlining a hierarchy of capability requirements, ranging from basic knowledge recitation to engaging in real therapeutic conversations. We evaluated representative LLMs on our benchmark. Experimental results indicate that while LLMs perform well in reciting CBT knowledge, they fall short in complex real-world scenarios requiring deep analysis of patients' cognitive structures and generating effective responses, suggesting potential future work.

In this paper, we delineate the strategy employed by our team, DeepLearningBrasil, which secured us the first place in the shared task DepSign-LT-EDI@RANLP-2023, achieving a 47.0% Macro F1-Score and a notable 2.4% advantage. The task was to classify social media texts into three distinct levels of depression - "not depressed," "moderately depressed," and "severely depressed." Leveraging the power of the RoBERTa and DeBERTa models, we further pre-trained them on a collected Reddit dataset, specifically curated from mental health-related Reddit's communities (Subreddits), leading to an enhanced understanding of nuanced mental health discourse. To address lengthy textual data, we used truncation techniques that retained the essence of the content by focusing on its beginnings and endings. Our model was robust against unbalanced data by incorporating sample weights into the loss. Cross-validation and ensemble techniques were then employed to combine our k-fold trained models, delivering an optimal solution. The accompanying code is made available for transparency and further development.

The early detection of mental health disorders from social media text is critical for enabling timely support, risk assessment, and referral to appropriate resources. This work introduces multiMentalRoBERTa, a fine-tuned RoBERTa model designed for multiclass classification of common mental health conditions, including stress, anxiety, depression, post-traumatic stress disorder (PTSD), suicidal ideation, and neutral discourse. Drawing on multiple curated datasets, data exploration is conducted to analyze class overlaps, revealing strong correlations between depression and suicidal ideation as well as anxiety and PTSD, while stress emerges as a broad, overlapping category. Comparative experiments with traditional machine learning methods, domain-specific transformers, and prompting-based large language models demonstrate that multiMentalRoBERTa achieves superior performance, with macro F1-scores of 0.839 in the six-class setup and 0.870 in the five-class setup (excluding stress), outperforming both fine-tuned MentalBERT and baseline classifiers. Beyond predictive accuracy, explainability methods, including Layer Integrated Gradients and KeyBERT, are applied to identify lexical cues that drive classification, with a particular focus on distinguishing depression from suicidal ideation. The findings emphasize the effectiveness of fine-tuned transformers for reliable and interpretable detection in sensitive contexts, while also underscoring the importance of fairness, bias mitigation, and human-in-the-loop safety protocols. Overall, multiMentalRoBERTa is presented as a lightweight, robust, and deployable solution for enhancing support in mental health platforms.

Social media has become a valuable resource for the study of suicidal ideation and the assessment of suicide risk. Among social media platforms, Reddit has emerged as the most promising one due to its anonymity and its focus on topic-based communities (subreddits) that can be indicative of someone's state of mind or interest regarding mental health disorders such as r/SuicideWatch, r/Anxiety, r/depression. A challenge for previous work on suicide risk assessment has been the small amount of labeled data. We propose an empirical investigation into several classes of weakly-supervised approaches, and show that using pseudo-labeling based on related issues around mental health (e.g., anxiety, depression) helps improve model performance for suicide risk assessment.

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.

Evaluating Large Language Models (LLMs) for mental health support is challenging due to the emotionally and cognitively complex nature of therapeutic dialogue. Existing benchmarks are limited in scale, reliability, often relying on synthetic or social media data, and lack frameworks to assess when automated judges can be trusted. To address the need for large-scale dialogue datasets and judge reliability assessment, we introduce two benchmarks that provide a framework for generation and evaluation. MentalBench-100k consolidates 10,000 one-turn conversations from three real scenarios datasets, each paired with nine LLM-generated responses, yielding 100,000 response pairs. MentalAlign-70k}reframes evaluation by comparing four high-performing LLM judges with human experts across 70,000 ratings on seven attributes, grouped into Cognitive Support Score (CSS) and Affective Resonance Score (ARS). We then employ the Affective Cognitive Agreement Framework, a statistical methodology using intraclass correlation coefficients (ICC) with confidence intervals to quantify agreement, consistency, and bias between LLM judges and human experts. Our analysis reveals systematic inflation by LLM judges, strong reliability for cognitive attributes such as guidance and informativeness, reduced precision for empathy, and some unreliability in safety and relevance. Our contributions establish new methodological and empirical foundations for reliable, large-scale evaluation of LLMs in mental health. We release the benchmarks and codes at: https://github.com/abeerbadawi/MentalBench/

Chain of Thought (CoT) is significant in improving the reasoning abilities of large language models (LLMs). However, the correlation between the effectiveness of CoT and the length of reasoning steps in prompts remains largely unknown. To shed light on this, we have conducted several empirical experiments to explore the relations. Specifically, we design experiments that expand and compress the rationale reasoning steps within CoT demonstrations, while keeping all other factors constant. We have the following key findings. First, the results indicate that lengthening the reasoning steps in prompts, even without adding new information into the prompt, considerably enhances LLMs' reasoning abilities across multiple datasets. Alternatively, shortening the reasoning steps, even while preserving the key information, significantly diminishes the reasoning abilities of models. This finding highlights the importance of the number of steps in CoT prompts and provides practical guidance to make better use of LLMs' potential in complex problem-solving scenarios. Second, we also investigated the relationship between the performance of CoT and the rationales used in demonstrations. Surprisingly, the result shows that even incorrect rationales can yield favorable outcomes if they maintain the requisite length of inference. Third, we observed that the advantages of increasing reasoning steps are task-dependent: simpler tasks require fewer steps, whereas complex tasks gain significantly from longer inference sequences.

Large Reasoning Models (LRMs) have shown impressive capabilities in multi-step reasoning tasks. However, alongside these successes, a more deceptive form of model error has emerged--Reasoning Hallucination--where logically coherent but factually incorrect reasoning traces lead to persuasive yet faulty conclusions. Unlike traditional hallucinations, these errors are embedded within structured reasoning, making them more difficult to detect and potentially more harmful. In this work, we investigate reasoning hallucinations from a mechanistic perspective. We propose the Reasoning Score, which quantifies the depth of reasoning by measuring the divergence between logits obtained from projecting late layers of LRMs to the vocabulary space, effectively distinguishing shallow pattern-matching from genuine deep reasoning. Using this score, we conduct an in-depth analysis on the ReTruthQA dataset and identify two key reasoning hallucination patterns: early-stage fluctuation in reasoning depth and incorrect backtracking to flawed prior steps. These insights motivate our Reasoning Hallucination Detection (RHD) framework, which achieves state-of-the-art performance across multiple domains. To mitigate reasoning hallucinations, we further introduce GRPO-R, an enhanced reinforcement learning algorithm that incorporates step-level deep reasoning rewards via potential-based shaping. Our theoretical analysis establishes stronger generalization guarantees, and experiments demonstrate improved reasoning quality and reduced hallucination rates.

Large Reasoning Models (LRMs), which autonomously produce a reasoning Chain of Thought (CoT) before producing final responses, offer a promising approach to interpreting and monitoring model behaviors. Inspired by the observation that certain CoT patterns -- e.g., ``Wait, did I miss anything?'' -- consistently emerge across tasks, we explore whether LRMs exhibit human-like cognitive habits. Building on Habits of Mind, a well-established framework of cognitive habits associated with successful human problem-solving, we introduce CogTest, a principled benchmark designed to evaluate LRMs' cognitive habits. CogTest includes 16 cognitive habits, each instantiated with 25 diverse tasks, and employs an evidence-first extraction method to ensure reliable habit identification. With CogTest, we conduct a comprehensive evaluation of 16 widely used LLMs (13 LRMs and 3 non-reasoning ones). Our findings reveal that LRMs, unlike conventional LLMs, not only exhibit human-like habits but also adaptively deploy them according to different tasks. Finer-grained analyses further uncover patterns of similarity and difference in LRMs' cognitive habit profiles, particularly certain inter-family similarity (e.g., Qwen-3 models and DeepSeek-R1). Extending the study to safety-related tasks, we observe that certain habits, such as Taking Responsible Risks, are strongly associated with the generation of harmful responses. These findings suggest that studying persistent behavioral patterns in LRMs' CoTs is a valuable step toward deeper understanding of LLM misbehavior. The code is available at: https://github.com/jianshuod/CogTest.

Mental health disorders are a global crisis. While various datasets exist for detecting such disorders, there remains a critical gap in identifying individuals actively seeking help. This paper introduces a novel dataset, M-Help, specifically designed to detect help-seeking behavior on social media. The dataset goes beyond traditional labels by identifying not only help-seeking activity but also specific mental health disorders and their underlying causes, such as relationship challenges or financial stressors. AI models trained on M-Help can address three key tasks: identifying help-seekers, diagnosing mental health conditions, and uncovering the root causes of issues.

Large language models (LLMs) hold significant potential for mental health support, capable of generating empathetic responses and simulating therapeutic conversations. However, existing LLM-based approaches often lack the clinical grounding necessary for real-world psychological counseling, particularly in explicit diagnostic reasoning aligned with standards like the DSM/ICD and incorporating diverse therapeutic modalities beyond basic empathy or single strategies. To address these critical limitations, we propose PsyLLM, the first large language model designed to systematically integrate both diagnostic and therapeutic reasoning for mental health counseling. To develop the PsyLLM, we propose a novel automated data synthesis pipeline. This pipeline processes real-world mental health posts, generates multi-turn dialogue structures, and leverages LLMs guided by international diagnostic standards (e.g., DSM/ICD) and multiple therapeutic frameworks (e.g., CBT, ACT, psychodynamic) to simulate detailed clinical reasoning processes. Rigorous multi-dimensional filtering ensures the generation of high-quality, clinically aligned dialogue data. In addition, we introduce a new benchmark and evaluation protocol, assessing counseling quality across four key dimensions: comprehensiveness, professionalism, authenticity, and safety. Our experiments demonstrate that PsyLLM significantly outperforms state-of-the-art baseline models on this benchmark.

Large language models (LLMs) have been routinely used to solve various tasks using step-by-step reasoning. However, the structure of intermediate reasoning steps, or thoughts, is rigid and unidirectional, such as chains, trees, or acyclic-directed graphs. Consequently, the resulting inflexible and forward-only reasoning may not address challenging tasks and fail when the LLM frequently gives false responses, i.e., ``hallucinations''. This paper proposes a new reasoning framework, called Thought Rollback (TR), allowing LLMs to adaptively build thought structure while maintaining effective reasoning toward problem-solving under ``hallucinations''. The core mechanism of TR is rolling back thoughts, which allows LLMs to perform error analysis on thoughts, and thus roll back to any previously mistaken thought for revision. Subsequently, by including such trial-and-error in the prompt to guide the LLM, each rollback leads to one more reliable reasoning path. Therefore, starting with a simple prompt without human annotations, LLM with TR adaptively and gradually explores thoughts for a correct solution. Comprehensive experiments on mathematical problems and multi-task reasoning demonstrate the state-of-the-art performance of TR in terms of problem-solving rate and interaction cost. For instance, the solving rate of GPT-4 with TR outperforms the current best by 9% on the MATH dataset.

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

Recently evolved large reasoning models (LRMs) show powerful performance in solving complex tasks with long chain-of-thought (CoT) reasoning capability. As these LRMs are mostly developed by post-training on formal reasoning tasks, whether they generalize the reasoning capability to help reduce hallucination in fact-seeking tasks remains unclear and debated. For instance, DeepSeek-R1 reports increased performance on SimpleQA, a fact-seeking benchmark, while OpenAI-o3 observes even severer hallucination. This discrepancy naturally raises the following research question: Are reasoning models more prone to hallucination? This paper addresses the question from three perspectives. (1) We first conduct a holistic evaluation for the hallucination in LRMs. Our analysis reveals that LRMs undergo a full post-training pipeline with cold start supervised fine-tuning (SFT) and verifiable reward RL generally alleviate their hallucination. In contrast, both distillation alone and RL training without cold start fine-tuning introduce more nuanced hallucinations. (2) To explore why different post-training pipelines alters the impact on hallucination in LRMs, we conduct behavior analysis. We characterize two critical cognitive behaviors that directly affect the factuality of a LRM: Flaw Repetition, where the surface-level reasoning attempts repeatedly follow the same underlying flawed logic, and Think-Answer Mismatch, where the final answer fails to faithfully match the previous CoT process. (3) Further, we investigate the mechanism behind the hallucination of LRMs from the perspective of model uncertainty. We find that increased hallucination of LRMs is usually associated with the misalignment between model uncertainty and factual accuracy. Our work provides an initial understanding of the hallucination in LRMs.

Chain-of-thought (CoT) prompting has become a widely used strategy for working with large language and multimodal models. While CoT has been shown to improve performance across many tasks, determining the settings in which it is effective remains an ongoing effort. In particular, it is still an open question in what settings CoT systematically reduces model performance. In this paper, we seek to identify the characteristics of tasks where CoT reduces performance by drawing inspiration from cognitive psychology, looking at cases where (i) verbal thinking or deliberation hurts performance in humans, and (ii) the constraints governing human performance generalize to language models. Three such cases are implicit statistical learning, visual recognition, and classifying with patterns containing exceptions. In extensive experiments across all three settings, we find that a diverse collection of state-of-the-art models exhibit significant drop-offs in performance (e.g., up to 36.3% absolute accuracy for OpenAI o1-preview compared to GPT-4o) when using inference-time reasoning compared to zero-shot counterparts. We also identify three tasks that satisfy condition (i) but not (ii), and find that while verbal thinking reduces human performance in these tasks, CoT retains or increases model performance. Overall, our results show that while there is not an exact parallel between the cognitive processes of models and those of humans, considering cases where thinking has negative consequences for human performance can help us identify settings where it negatively impacts models. By connecting the literature on human deliberation with evaluations of CoT, we offer a new tool that can be used in understanding the impact of prompt choices and inference-time reasoning.

Recent Large Reasoning Models (LRMs) excel at complex reasoning tasks but often suffer from overthinking, generating overly long and redundant reasoning trajectories. To explore its essence, our empirical analysis reveals that LRMs are primarily limited to recognizing task properties (i.e., difficulty levels) like humans before solving the problem, leading to a one-size-fits-all reasoning process. Inspired by this, a pressing and natural question emerges: Can we explicitly bootstrap such ability to alleviate overthinking in LRMs? In this paper, we propose Think-How-to-Think (TH2T), a novel two-stage fine-tuning strategy that progressively inspires LRMs' difficulty cognition and redundancy cognition of LRMs. Specifically, we first inject difficulty hypnosis into output prefixes to guide the model toward adaptive reasoning depth, trained on a hybrid dataset mixing short and long reasoning paths. Then, we incorporate redundancy hypnosis, which supervises the intermediate reasoning steps to identify and eliminate unnecessary reasoning patterns. Experiments on 7B/14B/32B models demonstrate that TH2T significantly reduces inference costs by over 70% on easy tasks and 40% on hard tasks while maintaining performance stability. The resulting outputs exhibit clear signs of difficulty-aware capabilities and reduced redundancy (e.g., reflection and looping).

Large Language Models, such as Generative Pre-trained Transformer 3 (aka. GPT-3), have been developed to understand language through the analysis of extensive text data, allowing them to identify patterns and connections between words. While LLMs have demonstrated impressive performance across various text-related tasks, they encounter challenges in tasks associated with reasoning. To address this challenge, Chain of Thought(CoT) prompting method has been proposed as a means to enhance LLMs' proficiency in complex reasoning tasks like solving math word problems and answering questions based on logical argumentative reasoning. The primary aim of this research is to assess how well four language models can grade reflective essays of third-year medical students. The assessment will specifically target the evaluation of critical thinking skills using CoT prompting. The research will provide the following contributions; to introduce and educate on the process of instructing models to evaluate reflective essays from a dataset they have not been previously trained on; to illustrate the use of CoT prompting as an instructional approach for training large models to carry out particular tasks. Our results suggest that among all the models, Llama-7b performs the least effectively, displaying the highest mean squared error. Conversely, ChatGPT emerges as the superior model, boasting a higher Cohen kappa score value of 0.53. Lastly, it's important to note that the selected models do prioritise user privacy by allowing users to delete their own conducted conversations.

While prior work has explored whether large language models (LLMs) possess a "theory of mind" (ToM) - the ability to attribute mental states to oneself and others - there has been little work testing whether LLMs can implicitly apply such knowledge to predict behavior, or to judge whether an observed behavior is rational. Such skills are critical for appropriate interaction in social environments. We create a new dataset, SimpleTom, containing concise, diverse stories (e.g., "The can of Pringles has moldy chips in it. Mary picks up the can in the supermarket and walks to the cashier."), each with three questions that test different degrees of ToM reasoning, asking models to predict (a) mental state ("Is Mary aware of the mold?"), (b) behavior ("Will Mary pay for the chips or report the mold?"), and (c) judgment ("Mary paid for the chips. Was that reasonable?"). To our knowledge, SimpleToM is the first dataset to systematically explore downstream reasoning requiring knowledge of mental states in realistic scenarios. Our experimental results are intriguing: While most models can reliably predict mental state on our dataset (a), they often fail to correctly predict the behavior (b), and fare even worse at judging whether given behaviors are reasonable (c), despite being correctly aware of the protagonist's mental state should make such secondary predictions obvious. We further show that we can help models do better at (b) and (c) via interventions such as reminding the model of its earlier mental state answer and mental-state-specific chain-of-thought prompting, raising the action prediction accuracies (e.g., from 49.5% to 93.5% for GPT-4o) and judgment accuracies (e.g., from 15.3% to 94.7% in GPT-4o). While this shows that models can be coaxed to perform well, it requires task-specific interventions, and the natural model performances remain low, a cautionary tale for LLM deployment.

In mental health counseling, a variety of earlier studies have focused on dialogue modeling. However, most of these studies give limited to no emphasis on the quality of interaction between a patient and a therapist. The therapeutic bond between a patient and a therapist directly correlates with effective mental health counseling. It involves developing the patient's trust on the therapist over the course of counseling. To assess the therapeutic bond in counseling, we introduce trust as a therapist-assistive metric. Our definition of trust involves patients' willingness and openness to express themselves and, consequently, receive better care. We conceptualize it as a dynamic trajectory observable through textual interactions during the counseling. To facilitate trust modeling, we present MENTAL-TRUST, a novel counseling dataset comprising manual annotation of 212 counseling sessions with first-of-its-kind seven expert-verified ordinal trust levels. We project our problem statement as an ordinal classification task for trust quantification and propose a new benchmark, TrustBench, comprising a suite of classical and state-of-the-art language models on MENTAL-TRUST. We evaluate the performance across a suite of metrics and lay out an exhaustive set of findings. Our study aims to unfold how trust evolves in therapeutic interactions.

Large language models (LLMs) often generate hallucinations -- unsupported content that undermines reliability. While most prior works frame hallucination detection as a binary task, many real-world applications require identifying hallucinated spans, which is a multi-step decision making process. This naturally raises the question of whether explicit reasoning can help the complex task of detecting hallucination spans. To answer this question, we first evaluate pretrained models with and without Chain-of-Thought (CoT) reasoning, and show that CoT reasoning has the potential to generate at least one correct answer when sampled multiple times. Motivated by this, we propose RL4HS, a reinforcement learning framework that incentivizes reasoning with a span-level reward function. RL4HS builds on Group Relative Policy Optimization and introduces Class-Aware Policy Optimization to mitigate reward imbalance issue. Experiments on the RAGTruth benchmark (summarization, question answering, data-to-text) show that RL4HS surpasses pretrained reasoning models and supervised fine-tuning, demonstrating the necessity of reinforcement learning with span-level rewards for detecting hallucination spans.

Generating a Chain of Thought (CoT) has been shown to consistently improve large language model (LLM) performance on a wide range of NLP tasks. However, prior work has mainly focused on logical reasoning tasks (e.g. arithmetic, commonsense QA); it remains unclear whether improvements hold for more diverse types of reasoning, especially in socially situated contexts. Concretely, we perform a controlled evaluation of zero-shot CoT across two socially sensitive domains: harmful questions and stereotype benchmarks. We find that zero-shot CoT reasoning in sensitive domains significantly increases a model's likelihood to produce harmful or undesirable output, with trends holding across different prompt formats and model variants. Furthermore, we show that harmful CoTs increase with model size, but decrease with improved instruction following. Our work suggests that zero-shot CoT should be used with caution on socially important tasks, especially when marginalized groups or sensitive topics are involved.

The COVID-19 pandemic has escalated mental health crises worldwide, with social isolation and economic instability contributing to a rise in suicidal behavior. Suicide can result from social factors such as shame, abuse, abandonment, and mental health conditions like depression, Post-Traumatic Stress Disorder (PTSD), Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety disorders, and bipolar disorders. As these conditions develop, signs of suicidal ideation may manifest in social media interactions. Analyzing social media data using artificial intelligence (AI) techniques can help identify patterns of suicidal behavior, providing invaluable insights for suicide prevention agencies, professionals, and broader community awareness initiatives. Machine learning algorithms for this purpose require large volumes of accurately labeled data. Previous research has not fully explored the potential of incorporating explanations in analyzing and labeling longitudinal social media data. In this study, we employed a model explanation method, Layer Integrated Gradients, on top of a fine-tuned state-of-the-art language model, to assign each token from Reddit users' posts an attribution score for predicting suicidal ideation. By extracting and analyzing attributions of tokens from the data, we propose a methodology for preliminary screening of social media posts for suicidal ideation without using large language models during inference.

Mental health has attracted substantial attention in recent years and LLM can be an effective technology for alleviating this problem owing to its capability in text understanding and dialogue. However, existing research in this domain often suffers from limitations, such as training on datasets lacking crucial prior knowledge and evidence, and the absence of comprehensive evaluation methods. In this paper, we propose a specialized psychological large language model (LLM), named PsycoLLM, trained on a proposed high-quality psychological dataset, including single-turn QA, multi-turn dialogues enriched with prior knowledge and knowledge-based QA. Additionally, to compare the performance of PsycoLLM with other LLMs, we develop a comprehensive psychological benchmark based on authoritative psychological counseling examinations in China, which includes assessments of professional ethics, theoretical proficiency, and case analysis. The experimental results on the benchmark illustrates the effectiveness of PsycoLLM, which demonstrates superior performance compared to other LLMs.

Multimodal large language models (MLLMs) have begun to demonstrate robust reasoning capabilities on general tasks, yet their application in the medical domain remains in its early stages. Constructing chain-of-thought (CoT) training data is essential for bolstering the reasoning abilities of medical MLLMs. However, existing approaches exhibit a deficiency in offering a comprehensive framework for searching and evaluating effective reasoning paths towards critical diagnosis. To address this challenge, we propose Mentor-Intern Collaborative Search (MICS), a novel reasoning-path searching scheme to generate rigorous and effective medical CoT data. MICS first leverages mentor models to initialize the reasoning, one step at a time, then prompts each intern model to continue the thinking along those initiated paths, and finally selects the optimal reasoning path according to the overall reasoning performance of multiple intern models. The reasoning performance is determined by an MICS-Score, which assesses the quality of generated reasoning paths. Eventually, we construct MMRP, a multi-task medical reasoning dataset with ranked difficulty, and Chiron-o1, a new medical MLLM devised via a curriculum learning strategy, with robust visual question-answering and generalizable reasoning capabilities. Extensive experiments demonstrate that Chiron-o1, trained on our CoT dataset constructed using MICS, achieves state-of-the-art performance across a list of medical visual question answering and reasoning benchmarks. Codes are available at GitHub - manglu097/Chiron-o1: Enhancing Step-by-Step and Verifiable Medical Reasoning in MLLMs

Great research interests have been attracted to devise AI services that are able to provide mental health support. However, the lack of corpora is a main obstacle to this research, particularly in Chinese language. In this paper, we propose PsyQA, a Chinese dataset of psychological health support in the form of question and answer pair. PsyQA is crawled from a Chinese mental health service platform, and contains 22K questions and 56K long and well-structured answers. Based on the psychological counseling theories, we annotate a portion of answer texts with typical strategies for providing support, and further present in-depth analysis of both lexical features and strategy patterns in the counseling answers. We also evaluate the performance of generating counseling answers with the generative pretrained models. Results show that utilizing strategies enhances the fluency and helpfulness of generated answers, but there is still a large space for future research.

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

Reasoning is a fundamental aspect of human intelligence that plays a crucial role in activities such as problem solving, decision making, and critical thinking. In recent years, large language models (LLMs) have made significant progress in natural language processing, and there is observation that these models may exhibit reasoning abilities when they are sufficiently large. However, it is not yet clear to what extent LLMs are capable of reasoning. This paper provides a comprehensive overview of the current state of knowledge on reasoning in LLMs, including techniques for improving and eliciting reasoning in these models, methods and benchmarks for evaluating reasoning abilities, findings and implications of previous research in this field, and suggestions on future directions. Our aim is to provide a detailed and up-to-date review of this topic and stimulate meaningful discussion and future work.

Reasoning has become a central paradigm for large language models (LLMs), consistently boosting accuracy across diverse benchmarks. Yet its suitability for precision-sensitive tasks remains unclear. We present the first systematic study of reasoning for classification tasks under strict low false positive rate (FPR) regimes. Our analysis covers two tasks--safety detection and hallucination detection--evaluated in both fine-tuned and zero-shot settings, using standard LLMs and Large Reasoning Models (LRMs). Our results reveal a clear trade-off: Think On (reasoning-augmented) generation improves overall accuracy, but underperforms at the low-FPR thresholds essential for practical use. In contrast, Think Off (no reasoning during inference) dominates in these precision-sensitive regimes, with Think On surpassing only when higher FPRs are acceptable. In addition, we find token-based scoring substantially outperforms self-verbalized confidence for precision-sensitive deployments. Finally, a simple ensemble of the two modes recovers the strengths of each. Taken together, our findings position reasoning as a double-edged tool: beneficial for average accuracy, but often ill-suited for applications requiring strict precision.

Chain-of-thought (CoT), tree-of-thought (ToT), and related techniques work surprisingly well in practice for some complex reasoning tasks with Large Language Models (LLMs), but why? This work seeks the underlying reasons by conducting experimental case studies and linking the performance benefits to well-established sample and computational complexity principles in machine learning. We experimented with 6 reasoning tasks, ranging from grade school math, air travel planning, ..., to Blocksworld. The results suggest that (i) both CoT and ToT benefit significantly from task decomposition, which breaks a complex reasoning task into a sequence of steps with low sample complexity and explicitly outlines the reasoning structure, and (ii) for computationally hard reasoning tasks, the more sophisticated tree structure of ToT outperforms the linear structure of CoT. These findings provide useful guidelines for the use of LLM in solving reasoning tasks in practice.

Medical tasks such as diagnosis and treatment planning require precise and complex reasoning, particularly in life-critical domains. Unlike mathematical reasoning, medical reasoning demands meticulous, verifiable thought processes to ensure reliability and accuracy. However, there is a notable lack of datasets that provide transparent, step-by-step reasoning to validate and enhance the medical reasoning ability of AI models. To bridge this gap, we introduce MedReason, a large-scale high-quality medical reasoning dataset designed to enable faithful and explainable medical problem-solving in large language models (LLMs). We utilize a structured medical knowledge graph (KG) to convert clinical QA pairs into logical chains of reasoning, or ``thinking paths'', which trace connections from question elements to answers via relevant KG entities. Each path is validated for consistency with clinical logic and evidence-based medicine. Our pipeline generates detailed reasoning for various medical questions from 7 medical datasets, resulting in a dataset of 32,682 question-answer pairs, each with detailed, step-by-step explanations. Experiments demonstrate that fine-tuning with our dataset consistently boosts medical problem-solving capabilities, achieving significant gains of up to 7.7% for DeepSeek-Ditill-8B. Our top-performing model, MedReason-8B, outperforms the Huatuo-o1-8B, a state-of-the-art medical reasoning model, by up to 4.2% on the clinical benchmark MedBullets. We also engage medical professionals from diverse specialties to assess our dataset's quality, ensuring MedReason offers accurate and coherent medical reasoning. Our data, models, and code will be publicly available.

Social and behavioral determinants of health (SDOH) play a significant role in shaping health outcomes, and extracting these determinants from clinical notes is a first step to help healthcare providers systematically identify opportunities to provide appropriate care and address disparities. Progress on using NLP methods for this task has been hindered by the lack of high-quality publicly available labeled data, largely due to the privacy and regulatory constraints on the use of real patients' information. This paper introduces a new dataset, SDOH-NLI, that is based on publicly available notes and which we release publicly. We formulate SDOH extraction as a natural language inference (NLI) task, and provide binary textual entailment labels obtained from human raters for a cross product of a set of social history snippets as premises and SDOH factors as hypotheses. Our dataset differs from standard NLI benchmarks in that our premises and hypotheses are obtained independently. We evaluate both "off-the-shelf" entailment models as well as models fine-tuned on our data, and highlight the ways in which our dataset appears more challenging than commonly used NLI datasets.

Mental health research through data-driven methods has been hindered by a lack of standard typology and scarcity of adequate data. In this study, we leverage the clinical articulation of depression to build a typology for social media texts for detecting the severity of depression. It emulates the standard clinical assessment procedure Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and Patient Health Questionnaire (PHQ-9) to encompass subtle indications of depressive disorders from tweets. Along with the typology, we present a new dataset of 40191 tweets labeled by expert annotators. Each tweet is labeled as 'non-depressed' or 'depressed'. Moreover, three severity levels are considered for 'depressed' tweets: (1) mild, (2) moderate, and (3) severe. An associated confidence score is provided with each label to validate the quality of annotation. We examine the quality of the dataset via representing summary statistics while setting strong baseline results using attention-based models like BERT and DistilBERT. Finally, we extensively address the limitations of the study to provide directions for further research.

Equipped with Chain-of-Thought (CoT), Large language models (LLMs) have shown impressive reasoning ability in various downstream tasks. Even so, suffering from hallucinations and the inability to access external knowledge, LLMs often come with incorrect or unfaithful intermediate reasoning steps, especially in the context of answering knowledge-intensive tasks such as KBQA. To alleviate this issue, we propose a framework called Knowledge-Driven Chain-of-Thought (KD-CoT) to verify and modify reasoning traces in CoT via interaction with external knowledge, and thus overcome the hallucinations and error propagation. Concretely, we formulate the CoT rationale process of LLMs into a structured multi-round QA format. In each round, LLMs interact with a QA system that retrieves external knowledge and produce faithful reasoning traces based on retrieved precise answers. The structured CoT reasoning of LLMs is facilitated by our developed KBQA CoT collection, which serves as in-context learning demonstrations and can also be utilized as feedback augmentation to train a robust retriever. Extensive experiments on WebQSP and ComplexWebQuestion datasets demonstrate the effectiveness of proposed KD-CoT in task-solving reasoning generation, which outperforms the vanilla CoT ICL with an absolute success rate of 8.0% and 5.1%. Furthermore, our proposed feedback-augmented retriever outperforms the state-of-the-art baselines for retrieving knowledge, achieving significant improvement in Hit performance.

Mobile mental health applications are seen as a promising way to fulfill the growing need for mental health care. Although there are more than ten thousand mental health apps available on app marketplaces, such as Google Play and Apple App Store, many of them are not evidence-based, or have been minimally evaluated or regulated. The real-life experience and concerns of the app users are largely unknown. To address this knowledge gap, we analyzed 2159 user reviews from 117 Android apps and 2764 user reviews from 76 iOS apps. Our findings include the critiques around inconsistent moderation standards and lack of transparency. App-embedded social features and chatbots were criticized for providing little support during crises. We provide research and design implications for future mental health app developers, discuss the necessity of developing a comprehensive and centralized app development guideline, and the opportunities of incorporating existing AI technology in mental health chatbots.

Abstract reasoning is a key ability for an intelligent system. Large language models achieve above-chance performance on abstract reasoning tasks, but exhibit many imperfections. However, human abstract reasoning is also imperfect, and depends on our knowledge and beliefs about the content of the reasoning problem. For example, humans reason much more reliably about logical rules that are grounded in everyday situations than arbitrary rules about abstract attributes. The training experiences of language models similarly endow them with prior expectations that reflect human knowledge and beliefs. We therefore hypothesized that language models would show human-like content effects on abstract reasoning problems. We explored this hypothesis across three logical reasoning tasks: natural language inference, judging the logical validity of syllogisms, and the Wason selection task (Wason, 1968). We find that state of the art large language models (with 7 or 70 billion parameters; Hoffman et al., 2022) reflect many of the same patterns observed in humans across these tasks -- like humans, models reason more effectively about believable situations than unrealistic or abstract ones. Our findings have implications for understanding both these cognitive effects, and the factors that contribute to language model performance.

Chain-of-Thought (CoT) prompting has become the de facto method to elicit reasoning capabilities from large language models (LLMs). However, to mitigate hallucinations in CoT that are notoriously difficult to detect, current methods such as process reward models (PRMs) or self-consistency operate as opaque boxes and do not provide checkable evidence for their judgments, possibly limiting their effectiveness. To address this issue, we draw inspiration from the idea that "the gold standard for supporting a mathematical claim is to provide a proof". We propose a retrospective, step-aware formal verification framework Safe. Rather than assigning arbitrary scores, we strive to articulate mathematical claims in formal mathematical language Lean 4 at each reasoning step and provide formal proofs to identify hallucinations. We evaluate our framework Safe across multiple language models and various mathematical datasets, demonstrating a significant performance improvement while offering interpretable and verifiable evidence. We also propose FormalStep as a benchmark for step correctness theorem proving with 30,809 formal statements. To the best of our knowledge, our work represents the first endeavor to utilize formal mathematical language Lean 4 for verifying natural language content generated by LLMs, aligning with the reason why formal mathematical languages were created in the first place: to provide a robust foundation for hallucination-prone human-written proofs.

Recently, with the chain of thought (CoT) prompting, large language models (LLMs), e.g., GPT-3, have shown strong reasoning ability in several natural language processing tasks such as arithmetic, commonsense, and logical reasoning. However, LLMs with CoT require multi-step prompting and multi-token prediction, which is highly sensitive to individual mistakes and vulnerable to error accumulation. The above issues make the LLMs need the ability to verify the answers. In fact, after inferring conclusions in some thinking decision tasks, people often check them by re-verifying steps to avoid some mistakes. In this paper, we propose and prove that LLMs also have similar self-verification abilities. We take the conclusion obtained by CoT as one of the conditions for solving the original problem. By taking turns masking the original conditions and predicting their results, we calculate an explainable answer verification score based on whether the re-predicted conditions are correct. Experimental results demonstrate that the proposed method can improve the reasoning performance on various arithmetic, commonsense, and logical reasoning datasets. Our code is publicly available at: https://github.com/WENGSYX/Self-Verification.

We construct evaluation tasks where extending the reasoning length of Large Reasoning Models (LRMs) deteriorates performance, exhibiting an inverse scaling relationship between test-time compute and accuracy. Our evaluation tasks span four categories: simple counting tasks with distractors, regression tasks with spurious features, deduction tasks with constraint tracking, and advanced AI risks. We identify five distinct failure modes when models reason for longer: 1) Claude models become increasingly distracted by irrelevant information; 2) OpenAI o-series models resist distractors but overfit to problem framings; 3) models shift from reasonable priors to spurious correlations; 4) all models show difficulties in maintaining focus on complex deductive tasks; and 5) extended reasoning may amplify concerning behaviors, with Claude Sonnet 4 showing increased expressions of self-preservation. These findings suggest that while test-time compute scaling remains promising for improving model capabilities, it may inadvertently reinforce problematic reasoning patterns. Our results demonstrate the importance of evaluating models across diverse reasoning lengths to identify and address these failure modes in LRMs.

Large Language Models (LLMs) significantly benefit from Chain-of-Thought (CoT) prompting in performing various reasoning tasks. While CoT allows models to produce more comprehensive reasoning processes, its emphasis on intermediate reasoning steps can inadvertently introduce hallucinations and accumulated errors, thereby limiting models' ability to solve complex reasoning tasks. Inspired by how humans engage in careful and meticulous deductive logical reasoning processes to solve tasks, we seek to enable language models to perform explicit and rigorous deductive reasoning, and also ensure the trustworthiness of their reasoning process through self-verification. However, directly verifying the validity of an entire deductive reasoning process is challenging, even with advanced models like ChatGPT. In light of this, we propose to decompose a reasoning verification process into a series of step-by-step subprocesses, each only receiving their necessary context and premises. To facilitate this procedure, we propose Natural Program, a natural language-based deductive reasoning format. Our approach enables models to generate precise reasoning steps where subsequent steps are more rigorously grounded on prior steps. It also empowers language models to carry out reasoning self-verification in a step-by-step manner. By integrating this verification process into each deductive reasoning stage, we significantly enhance the rigor and trustfulness of generated reasoning steps. Along this process, we also improve the answer correctness on complex reasoning tasks. Code will be released at https://github.com/lz1oceani/verify_cot.

The recent advancements in artificial intelligence highlight the potential of language models in psychological health support. While models trained on data from mental health service platform have achieved preliminary success, challenges persist in areas such as data scarcity, quality, and ensuring a solid foundation in psychological techniques. To address these challenges, this study introduces a novel approach to enhance the precision and efficacy of psychological support through large language models. Specifically, we design a specific prompt derived from principles of Cognitive Behavioral Therapy (CBT) and have generated the CBT QA dataset, specifically for Chinese psychological health Q&A based on CBT structured intervention strategies. Unlike previous methods, our dataset emphasizes professional and structured response. Utilizing this dataset, we fine-tuned the large language model, giving birth to CBT-LLM, the large-scale language model specifically designed for Cognitive Behavioral Therapy techniques. Empirical evaluations demonstrate that CBT-LLM excels in generating structured, professional, and highly relevant responses in psychological health support tasks, showcasing its practicality and quality. The model is available on Hugging Face: https://huggingface.co/Hongbin37/CBT-LLM.

Simulating human clients in mental health counseling is crucial for training and evaluating counselors (both human or simulated) in a scalable manner. Nevertheless, past research on client simulation did not focus on complex conversation tasks such as mental health counseling. In these tasks, the challenge is to ensure that the client's actions (i.e., interactions with the counselor) are consistent with with its stipulated profiles and negative behavior settings. In this paper, we propose a novel framework that supports consistent client simulation for mental health counseling. Our framework tracks the mental state of a simulated client, controls its state transitions, and generates for each state behaviors consistent with the client's motivation, beliefs, preferred plan to change, and receptivity. By varying the client profile and receptivity, we demonstrate that consistent simulated clients for different counseling scenarios can be effectively created. Both our automatic and expert evaluations on the generated counseling sessions also show that our client simulation method achieves higher consistency than previous methods.

Reasoning is central to a wide range of intellectual activities, and while the capabilities of large language models (LLMs) continue to advance, their performance in reasoning tasks remains limited. The processes and mechanisms underlying reasoning are not yet fully understood, but key elements include path exploration, selection of relevant knowledge, and multi-step inference. Problems are solved through the synthesis of these components. In this paper, we propose a benchmark that focuses on a specific aspect of reasoning ability: the direct evaluation of multi-step inference. To this end, we design a special reasoning task where multi-step inference is specifically focused by largely eliminating path exploration and implicit knowledge utilization. Our dataset comprises pairs of explicit instructions and corresponding questions, where the procedures necessary for solving the questions are entirely detailed within the instructions. This setup allows models to solve problems solely by following the provided directives. By constructing problems that require varying numbers of steps to solve and evaluating responses at each step, we enable a thorough assessment of state-of-the-art LLMs' ability to follow instructions. To ensure the robustness of our evaluation, we include multiple distinct tasks. Furthermore, by comparing accuracy across tasks, utilizing step-aware metrics, and applying separately defined measures of complexity, we conduct experiments that offer insights into the capabilities and limitations of LLMs in reasoning tasks. Our findings have significant implications for the development of LLMs and highlight areas for future research in advancing their reasoning abilities. Our dataset is available at https://huggingface.co/datasets/ifujisawa/procbench and code at https://github.com/ifujisawa/proc-bench.

Online Mental Health Communities (OMHCs) provide crucial peer and expert support, yet many posts remain unanswered due to missing support attributes that signal the need for help. We present a novel framework that identifies these gaps and prompts users to enrich their posts, thereby improving engagement. To support this, we introduce REDDME, a new dataset of 4,760 posts from mental health subreddits annotated for the span and intensity of three key support attributes: event what happened?, effect what did the user experience?, and requirement what support they need?. Next, we devise a hierarchical taxonomy, CueTaxo, of support attributes for controlled question generation. Further, we propose MH-COPILOT, a reinforcement learning-based system that integrates (a) contextual attribute-span identification, (b) support attribute intensity classification, (c) controlled question generation via a hierarchical taxonomy, and (d) a verifier for reward modeling. Our model dynamically assesses posts for the presence/absence of support attributes, and generates targeted prompts to elicit missing information. Empirical results across four notable language models demonstrate significant improvements in attribute elicitation and user engagement. A human evaluation further validates the model's effectiveness in real-world OMHC settings.

We explore the potential of ChatGPT (3.5-turbo and 4) to generate conversations focused on self-care strategies for African-American heart failure patients -- a domain with limited specialized datasets. To simulate patient-health educator dialogues, we employed four prompting strategies: domain, African American Vernacular English (AAVE), Social Determinants of Health (SDOH), and SDOH-informed reasoning. Conversations were generated across key self-care domains of food, exercise, and fluid intake, with varying turn lengths (5, 10, 15) and incorporated patient-specific SDOH attributes such as age, gender, neighborhood, and socioeconomic status. Our findings show that effective prompt design is essential. While incorporating SDOH and reasoning improves dialogue quality, ChatGPT still lacks the empathy and engagement needed for meaningful healthcare communication.

Large Language Models (LLMs) have demonstrated remarkable performance across multiple tasks through in-context learning. For complex reasoning tasks that require step-by-step thinking, Chain-of-Thought (CoT) prompting has given impressive results, especially when combined with self-consistency. Nonetheless, some tasks remain particularly difficult for LLMs to solve. Tree of Thoughts (ToT) and Graph of Thoughts (GoT) emerged as alternatives, dividing the complex problem into paths of subproblems. In this paper, we propose Tree of Problems (ToP), a simpler version of ToT, which we hypothesise can work better for complex tasks that can be divided into identical subtasks. Our empirical results show that our approach outperforms ToT and GoT, and in addition performs better than CoT on complex reasoning tasks. All code for this paper is publicly available here: https://github.com/ArmelRandy/tree-of-problems.

Background: Emerging reports of "AI psychosis" are on the rise, where user-LLM interactions may exacerbate or induce psychosis or adverse psychological symptoms. Whilst the sycophantic and agreeable nature of LLMs can be beneficial, it becomes a vector for harm by reinforcing delusional beliefs in vulnerable users. Methods: Psychosis-bench is a novel benchmark designed to systematically evaluate the psychogenicity of LLMs comprises 16 structured, 12-turn conversational scenarios simulating the progression of delusional themes(Erotic Delusions, Grandiose/Messianic Delusions, Referential Delusions) and potential harms. We evaluated eight prominent LLMs for Delusion Confirmation (DCS), Harm Enablement (HES), and Safety Intervention(SIS) across explicit and implicit conversational contexts. Findings: Across 1,536 simulated conversation turns, all LLMs demonstrated psychogenic potential, showing a strong tendency to perpetuate rather than challenge delusions (mean DCS of 0.91 pm0.88). Models frequently enabled harmful user requests (mean HES of 0.69 pm0.84) and offered safety interventions in only roughly a third of applicable turns (mean SIS of 0.37 pm0.48). 51 / 128 (39.8%) of scenarios had no safety interventions offered. Performance was significantly worse in implicit scenarios, models were more likely to confirm delusions and enable harm while offering fewer interventions (p < .001). A strong correlation was found between DCS and HES (rs = .77). Model performance varied widely, indicating that safety is not an emergent property of scale alone. Conclusion: This study establishes LLM psychogenicity as a quantifiable risk and underscores the urgent need for re-thinking how we train LLMs. We frame this issue not merely as a technical challenge but as a public health imperative requiring collaboration between developers, policymakers, and healthcare professionals.

We introduce MentalChat16K, an English benchmark dataset combining a synthetic mental health counseling dataset and a dataset of anonymized transcripts from interventions between Behavioral Health Coaches and Caregivers of patients in palliative or hospice care. Covering a diverse range of conditions like depression, anxiety, and grief, this curated dataset is designed to facilitate the development and evaluation of large language models for conversational mental health assistance. By providing a high-quality resource tailored to this critical domain, MentalChat16K aims to advance research on empathetic, personalized AI solutions to improve access to mental health support services. The dataset prioritizes patient privacy, ethical considerations, and responsible data usage. MentalChat16K presents a valuable opportunity for the research community to innovate AI technologies that can positively impact mental well-being. The dataset is available at https://huggingface.co/datasets/ShenLab/MentalChat16K and the code and documentation are hosted on GitHub at https://github.com/ChiaPatricia/MentalChat16K.

Large Reasoning Models (LRMs) are transforming the AI landscape with advanced reasoning capabilities. While the generated reasoning traces enhance model transparency, they can still contain unsafe content, even when the final answer appears safe. Existing moderation tools, primarily designed for question-answer (QA) pairs, are empirically ineffective at detecting hidden risks embedded in reasoning traces. After identifying the key challenges, we formally define the question-thought (QT) moderation task and propose ReasoningShield, the first safety detection model tailored to identify potential risks in the reasoning trace before reaching the final answer. To construct the model, we synthesize a high-quality reasoning safety detection dataset comprising over 8,000 question-thought pairs spanning ten risk categories and three safety levels. Our dataset construction process incorporates a comprehensive human-AI collaborative annotation pipeline, which achieves over 93% annotation accuracy while significantly reducing human costs. On a diverse set of in-distribution and out-of-distribution benchmarks, ReasoningShield outperforms mainstream content safety moderation models in identifying risks within reasoning traces, with an average F1 score exceeding 0.92. Notably, despite being trained on our QT dataset only, ReasoningShield also demonstrates competitive performance in detecting unsafe question-answer pairs on traditional benchmarks, rivaling baselines trained on 10 times larger datasets and base models, which strongly validates the quality of our dataset. Furthermore, ReasoningShield is built upon compact 1B/3B base models to facilitate lightweight deployment and provides human-friendly risk analysis by default. To foster future research, we publicly release all the resources.

Large language models (LLMs) have made remarkable strides in various natural language processing tasks, but their performance on complex reasoning problems remains hindered by a lack of explainability and trustworthiness. This issue, often manifesting as hallucinations or unattributable reasoning processes, limits their applicability in complex reasoning scenarios. To address this, we propose Knowledge Graph-constrained Trajectory Reasoning Attribution and Chain Explanation Supervision (KG-TRACES), a novel framework that enhances the reasoning ability of LLMs through explicit supervision over reasoning paths and processes. KG-TRACES jointly supervises the model to: (1) predict symbolic relation paths, (2) predict full triple-level reasoning paths, and (3) generate attribution-aware reasoning processes grounded in the reasoning paths. At inference phase, the model adapts to both KG-available and KG-unavailable scenarios, retrieving reasoning paths from a KG when possible or predicting plausible reasoning paths with only intrinsic knowledge when not. This design enables the model to reason in an explainable and source-attributable pattern. Through extensive experiments on complex reasoning tasks, we demonstrate that KG-TRACES significantly outperforms existing SOTA: it improves Hits@1 by 1.6% and F1 by 4.7% on WebQSP, and achieves improvements of 4.8% in Hits@1 and 2.1% in F1 on CWQ. Moreover, we show its transferability to specialized domains such as medicine. By visualizing the intermediate steps of reasoning processes, we further show that the explicit supervision introduced by KG-TRACES leads to more stable and goal-directed reasoning processes, aligning closely with correct answers. Code is available at https://github.com/Edaizi/KG-TRACES.

Reasoning is a distinctive human capacity, enabling us to address complex problems by breaking them down into a series of manageable cognitive steps. Yet, complex logical reasoning is still cumbersome for language models. Based on the dual process theory in cognitive science, we are the first to unravel the cognitive reasoning abilities of language models. Our framework employs an iterative methodology to construct a Cognitive Tree (CogTree). The root node of this tree represents the initial query, while the leaf nodes consist of straightforward questions that can be answered directly. This construction involves two main components: the implicit extraction module (referred to as the intuitive system) and the explicit reasoning module (referred to as the reflective system). The intuitive system rapidly generates multiple responses by utilizing in-context examples, while the reflective system scores these responses using comparative learning. The scores guide the intuitive system in its subsequent generation step. Our experimental results on two popular and challenging reasoning tasks indicate that it is possible to achieve a performance level comparable to that of GPT-3.5 (with 175B parameters), using a significantly smaller language model that contains fewer parameters (<=7B) than 5% of GPT-3.5.

Hallucinations (i.e., generating plausible but inaccurate content) and laziness (i.e. excessive refusals or defaulting to "I don't know") persist as major challenges in LLM reasoning. Current efforts to reduce hallucinations primarily focus on factual errors in knowledge-grounded tasks, often neglecting hallucinations related to faulty reasoning. Meanwhile, some approaches render LLMs overly conservative, limiting their problem-solving capabilities. To mitigate hallucination and laziness in reasoning tasks, we propose Automatic Curriculum Expert Iteration (Auto-CEI) to enhance LLM reasoning and align responses to the model's capabilities--assertively answering within its limits and declining when tasks exceed them. In our method, Expert Iteration explores the reasoning trajectories near the LLM policy, guiding incorrect paths back on track to reduce compounding errors and improve robustness; it also promotes appropriate "I don't know" responses after sufficient reasoning attempts. The curriculum automatically adjusts rewards, incentivizing extended reasoning before acknowledging incapability, thereby pushing the limits of LLM reasoning and aligning its behaviour with these limits. We compare Auto-CEI with various SOTA baselines across logical reasoning, mathematics, and planning tasks, where Auto-CEI achieves superior alignment by effectively balancing assertiveness and conservativeness.

Emotional Support Conversation (ESC) plays a vital role in alleviating psychological stress and providing emotional value through dialogue. While recent studies have largely focused on data augmentation and synthetic corpus construction, they often overlook the deeper cognitive reasoning processes that underpin effective emotional support. To address this gap, we propose CARE, a novel framework that strengthens reasoning in ESC without relying on large-scale synthetic data. CARE leverages the original ESC training set to guide models in generating logically coherent and supportive responses, thereby explicitly enhancing cognitive reasoning. Building on this foundation, we further employ reinforcement learning to refine and reinforce the reasoning process. Experimental results demonstrate that CARE significantly improves both the logical soundness and supportive quality of responses, advancing the development of empathetic, cognitively robust, and human-like emotional support systems.

Mental illness remains one of the most critical public health issues. Despite its importance, many mental health professionals highlight a disconnect between their training and actual real-world patient practice. To help bridge this gap, we propose PATIENT-{\Psi}, a novel patient simulation framework for cognitive behavior therapy (CBT) training. To build PATIENT-{\Psi}, we construct diverse patient cognitive models based on CBT principles and use large language models (LLMs) programmed with these cognitive models to act as a simulated therapy patient. We propose an interactive training scheme, PATIENT-{\Psi}-TRAINER, for mental health trainees to practice a key skill in CBT -- formulating the cognitive model of the patient -- through role-playing a therapy session with PATIENT-{\Psi}. To evaluate PATIENT-{\Psi}, we conducted a comprehensive user study of 13 mental health trainees and 20 experts. The results demonstrate that practice using PATIENT-{\Psi}-TRAINER enhances the perceived skill acquisition and confidence of the trainees beyond existing forms of training such as textbooks, videos, and role-play with non-patients. Based on the experts' perceptions, PATIENT-{\Psi} is perceived to be closer to real patient interactions than GPT-4, and PATIENT-{\Psi}-TRAINER holds strong promise to improve trainee competencies. Our code and data are released at https://github.com/ruiyiw/patient-psi.

Mental distress like depression and anxiety contribute to the largest proportion of the global burden of diseases. Automated diagnosis systems of such disorders, empowered by recent innovations in Artificial Intelligence, can pave the way to reduce the sufferings of the affected individuals. Development of such systems requires information-rich and balanced corpora. In this work, we introduce a novel mental distress analysis audio dataset DEPAC, labeled based on established thresholds on depression and anxiety standard screening tools. This large dataset comprises multiple speech tasks per individual, as well as relevant demographic information. Alongside, we present a feature set consisting of hand-curated acoustic and linguistic features, which were found effective in identifying signs of mental illnesses in human speech. Finally, we justify the quality and effectiveness of our proposed audio corpus and feature set in predicting depression severity by comparing the performance of baseline machine learning models built on this dataset with baseline models trained on other well-known depression corpora.

Multi-hop question answering (MHQA) requires a model to retrieve and integrate information from multiple passages to answer a complex question. Recent systems leverage the power of large language models and integrate evidence retrieval with reasoning prompts (e.g., chain-of-thought reasoning) for the MHQA task. However, the complexities in the question types (bridge v.s. comparison questions) and the reasoning types (sequential v.s. parallel reasonings) require more novel and fine-grained prompting methods to enhance the performance of MHQA under the zero-shot setting. In this paper, we propose STOC-TOT, a stochastic tree-of-thought reasoning prompting method with constrained decoding for MHQA and conduct a detailed comparison with other reasoning prompts on different question types and reasoning types. Specifically, we construct a tree-like reasoning structure by prompting the model to break down the original question into smaller sub-questions to form different reasoning paths. In addition, we prompt the model to provide a probability estimation for each reasoning path at each reasoning step. At answer time, we conduct constrained decoding on the model to generate more grounded answers and reduce hallucination. Experiments comparing STOC-TOT with two MHQA datasets and five large language models showed that our framework outperforms other reasoning prompts by a significant margin.

Large language models (LLMs) have demonstrated impressive reasoning abilities in complex tasks. However, they lack up-to-date knowledge and experience hallucinations during reasoning, which can lead to incorrect reasoning processes and diminish their performance and trustworthiness. Knowledge graphs (KGs), which capture vast amounts of facts in a structured format, offer a reliable source of knowledge for reasoning. Nevertheless, existing KG-based LLM reasoning methods only treat KGs as factual knowledge bases and overlook the importance of their structural information for reasoning. In this paper, we propose a novel method called reasoning on graphs (RoG) that synergizes LLMs with KGs to enable faithful and interpretable reasoning. Specifically, we present a planning-retrieval-reasoning framework, where RoG first generates relation paths grounded by KGs as faithful plans. These plans are then used to retrieve valid reasoning paths from the KGs for LLMs to conduct faithful reasoning. Furthermore, RoG not only distills knowledge from KGs to improve the reasoning ability of LLMs through training but also allows seamless integration with any arbitrary LLMs during inference. Extensive experiments on two benchmark KGQA datasets demonstrate that RoG achieves state-of-the-art performance on KG reasoning tasks and generates faithful and interpretable reasoning results.

The development of AI for mental health is hindered by a lack of authentic therapy dialogues, due to strict privacy regulations and the fact that clinical sessions were historically rarely recorded. We present an LLM-driven pipeline that generates synthetic counseling dialogues based on structured client profiles and psychological questionnaires. Grounded on the principles of Cognitive Behavioral Therapy (CBT), our method creates synthetic therapeutic conversations for clinical disorders such as anxiety and depression. Our framework, SQPsych (Structured Questionnaire-based Psychotherapy), converts structured psychological input into natural language dialogues through therapist-client simulations. Due to data governance policies and privacy restrictions prohibiting the transmission of clinical questionnaire data to third-party services, previous methodologies relying on proprietary models are infeasible in our setting. We address this limitation by generating a high-quality corpus using open-weight LLMs, validated through human expert evaluation and LLM-based assessments. Our SQPsychLLM models fine-tuned on SQPsychConv achieve strong performance on counseling benchmarks, surpassing baselines in key therapeutic skills. Our findings highlight the potential of synthetic data to enable scalable, data-secure, and clinically informed AI for mental health support. We will release our code, models, and corpus at https://ai-mh.github.io/SQPsych

Chain-of-Thought(CoT) prompting and its variants explore equipping large language models (LLMs) with high-level reasoning abilities by emulating human-like linear cognition and logic. However, the human mind is complicated and mixed with both linear and nonlinear thinking. In this work, we propose Inferential Exclusion Prompting (IEP), a novel prompting that combines the principles of elimination and inference in order to guide LLMs to think non-linearly. IEP guides LLMs to plan and then utilize Natural Language Inference (NLI) to deduce each possible solution's entailment relation with context, commonsense, or facts, therefore yielding a broader perspective by thinking back for inferring. This forward planning and backward eliminating process allows IEP to better simulate the complex human thinking processes compared to other CoT-based methods, which only reflect linear cognitive processes. We conducted a series of empirical studies and have corroborated that IEP consistently outperforms CoT across various tasks. Additionally, we observe that integrating IEP and CoT further improves the LLMs' performance on certain tasks, highlighting the necessity of equipping LLMs with mixed logic processes. Moreover, to better evaluate comprehensive features inherent in human logic, we introduce Mental-Ability Reasoning Benchmark (MARB). The benchmark comprises six novel subtasks with a total of 9,115 questions, among which 1,685 are developed with hand-crafted rationale references. We believe both IEP and MARB can serve as a promising direction for unveiling LLMs' logic and verbal reasoning abilities and drive further advancements. MARB will be available at ~anonymity link soon.

While large language models show promise in medical applications, achieving expert-level clinical reasoning remains challenging due to the need for both accurate answers and transparent reasoning processes. To address this challenge, we introduce Fleming-R1, a model designed for verifiable medical reasoning through three complementary innovations. First, our Reasoning-Oriented Data Strategy (RODS) combines curated medical QA datasets with knowledge-graph-guided synthesis to improve coverage of underrepresented diseases, drugs, and multi-hop reasoning chains. Second, we employ Chain-of-Thought (CoT) cold start to distill high-quality reasoning trajectories from teacher models, establishing robust inference priors. Third, we implement a two-stage Reinforcement Learning from Verifiable Rewards (RLVR) framework using Group Relative Policy Optimization, which consolidates core reasoning skills while targeting persistent failure modes through adaptive hard-sample mining. Across diverse medical benchmarks, Fleming-R1 delivers substantial parameter-efficient improvements: the 7B variant surpasses much larger baselines, while the 32B model achieves near-parity with GPT-4o and consistently outperforms strong open-source alternatives. These results demonstrate that structured data design, reasoning-oriented initialization, and verifiable reinforcement learning can advance clinical reasoning beyond simple accuracy optimization. We release Fleming-R1 publicly to promote transparent, reproducible, and auditable progress in medical AI, enabling safer deployment in high-stakes clinical environments.

Large Language Models (LLMs) have succeeded remarkably in various natural language processing (NLP) tasks, yet their reasoning capabilities remain a fundamental challenge. While LLMs exhibit impressive fluency and factual recall, their ability to perform complex reasoning-spanning logical deduction, mathematical problem-solving, commonsense inference, and multi-step reasoning-often falls short of human expectations. This survey provides a comprehensive review of emerging techniques enhancing reasoning in LLMs. We categorize existing methods into key approaches, including prompting strategies (e.g., Chain-of-Thought reasoning, Self-Consistency, and Tree-of-Thought reasoning), architectural innovations (e.g., retrieval-augmented models, modular reasoning networks, and neuro-symbolic integration), and learning paradigms (e.g., fine-tuning with reasoning-specific datasets, reinforcement learning, and self-supervised reasoning objectives). Additionally, we explore evaluation frameworks used to assess reasoning in LLMs and highlight open challenges, such as hallucinations, robustness, and reasoning generalization across diverse tasks. By synthesizing recent advancements, this survey aims to provide insights into promising directions for future research and practical applications of reasoning-augmented LLMs.

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

As generative artificial intelligence (GAI) enters the mental health landscape, questions arise about how individuals weigh AI tools against human therapists. Drawing on the Health Belief Model (HBM), this study examined belief-based predictors of intention to use GAI and therapists across two populations: a university sample (N = 1,155) and a nationally representative adult sample (N = 651). Using repeated-measures ANOVA and LASSO regression, we found that therapists were consistently valued for emotional, relational, and personalization benefits, while GAI was favored for accessibility and affordability. Yet structural advantages alone did not predict adoption; emotional benefit and personalization emerged as decisive factors. Adoption patterns diverged across groups: students treated GAI as a complement, whereas national adults approached it as a substitute. Concerns about privacy and reliability constrained GAI use in both groups. These findings extend HBM to multi-modality contexts and highlight design implications for trustworthy, emotionally resonant digital mental health tools.

Large Reasoning Models (LRMs) extend large language models with explicit, multi-step reasoning traces to enhance transparency and performance on complex tasks. However, these reasoning traces can be redundant or logically inconsistent, making them a new source of hallucination that is difficult to detect. Existing hallucination detection methods focus primarily on answer-level uncertainty and often fail to detect hallucinations or logical inconsistencies arising from the model's reasoning trace. This oversight is particularly problematic for LRMs, where the explicit thinking trace is not only an important support to the model's decision-making process but also a key source of potential hallucination. To this end, we propose RACE (Reasoning and Answer Consistency Evaluation), a novel framework specifically tailored for hallucination detection in LRMs. RACE operates by extracting essential reasoning steps and computing four diagnostic signals: inter-sample consistency of reasoning traces, entropy-based answer uncertainty, semantic alignment between reasoning and answers, and internal coherence of reasoning. This joint analysis enables fine-grained hallucination detection even when the final answer appears correct. Experiments across datasets and different LLMs demonstrate that RACE outperforms existing hallucination detection baselines, offering a robust and generalizable solution for evaluating LRMs. Our code is available at: https://github.com/bebr2/RACE.

Large Language Models (LLMs) are usually aligned with "human values/preferences" to prevent harmful output. Discussions around the alignment of Large Language Models (LLMs) generally focus on preventing harmful outputs. However, in this paper, we argue that in health-related queries, over-alignment-leading to overly cautious responses-can itself be harmful, especially for people with anxiety and obsessive-compulsive disorder (OCD). This is not only unethical but also dangerous to the user, both mentally and physically. We also showed qualitative results that some LLMs exhibit varying degrees of alignment. Finally, we call for the development of LLMs with stronger reasoning capabilities that provide more tailored and nuanced responses to health queries. Warning: This paper contains materials that could trigger health anxiety or OCD.

Large Language Models (LLMs) have demonstrated significant potential in handling complex reasoning tasks through step-by-step rationale generation. However, recent studies have raised concerns regarding the hallucination and flaws in their reasoning process. Substantial efforts are being made to improve the reliability and faithfulness of the generated rationales. Some approaches model reasoning as planning, while others focus on annotating for process supervision. Nevertheless, the planning-based search process often results in high latency due to the frequent assessment of intermediate reasoning states and the extensive exploration space. Additionally, supervising the reasoning process with human annotation is costly and challenging to scale for LLM training. To address these issues, in this paper, we propose a framework to learn planning-based reasoning through direct preference optimization (DPO) on collected trajectories, which are ranked according to synthesized process rewards. Our results on challenging logical reasoning benchmarks demonstrate the effectiveness of our learning framework, showing that our 7B model can surpass the strong counterparts like GPT-3.5-Turbo.

Many cognitive approaches to well-being, such as recognizing and reframing unhelpful thoughts, have received considerable empirical support over the past decades, yet still lack truly widespread adoption in self-help format. A barrier to that adoption is a lack of adequately specific and diverse dedicated practice material. This work examines whether current language models can be leveraged to both produce a virtually unlimited quantity of practice material illustrating standard unhelpful thought patterns matching specific given contexts, and generate suitable positive reframing proposals. We propose PATTERNREFRAME, a novel dataset of about 10k examples of thoughts containing unhelpful thought patterns conditioned on a given persona, accompanied by about 27k positive reframes. By using this dataset to train and/or evaluate current models, we show that existing models can already be powerful tools to help generate an abundance of tailored practice material and hypotheses, with no or minimal additional model training required.

Reasoning large language models have recently achieved state-of-the-art performance in many fields. However, their long-form chain-of-thought reasoning creates interpretability challenges as each generated token depends on all previous ones, making the computation harder to decompose. We argue that analyzing reasoning traces at the sentence level is a promising approach to understanding reasoning processes. We present three complementary attribution methods: (1) a black-box method measuring each sentence's counterfactual importance by comparing final answers across 100 rollouts conditioned on the model generating that sentence or one with a different meaning; (2) a white-box method of aggregating attention patterns between pairs of sentences, which identified ``broadcasting'' sentences that receive disproportionate attention from all future sentences via ``receiver'' attention heads; (3) a causal attribution method measuring logical connections between sentences by suppressing attention toward one sentence and measuring the effect on each future sentence's tokens. Each method provides evidence for the existence of thought anchors, reasoning steps that have outsized importance and that disproportionately influence the subsequent reasoning process. These thought anchors are typically planning or backtracking sentences. We provide an open-source tool (www.thought-anchors.com) for visualizing the outputs of our methods, and present a case study showing converging patterns across methods that map how a model performs multi-step reasoning. The consistency across methods demonstrates the potential of sentence-level analysis for a deeper understanding of reasoning models.

Mental health conditions affect hundreds of millions globally, yet early detection remains limited. While large language models (LLMs) have shown promise in mental health applications, their size and computational demands hinder practical deployment. Small language models (SLMs) offer a lightweight alternative, but their use for social media--based mental health prediction remains largely underexplored. In this study, we introduce Menta, the first optimized SLM fine-tuned specifically for multi-task mental health prediction from social media data. Menta is jointly trained across six classification tasks using a LoRA-based framework, a cross-dataset strategy, and a balanced accuracy--oriented loss. Evaluated against nine state-of-the-art SLM baselines, Menta achieves an average improvement of 15.2\% across tasks covering depression, stress, and suicidality compared with the best-performing non--fine-tuned SLMs. It also achieves higher accuracy on depression and stress classification tasks compared to 13B-parameter LLMs, while being approximately 3.25x smaller. Moreover, we demonstrate real-time, on-device deployment of Menta on an iPhone 15 Pro Max, requiring only approximately 3GB RAM. Supported by a comprehensive benchmark against existing SLMs and LLMs, Menta highlights the potential for scalable, privacy-preserving mental health monitoring. Code is available at: https://xxue752-nz.github.io/menta-project/

Suicide is an important but often misunderstood problem, one that researchers are now seeking to better understand through social media. Due in large part to the fuzzy nature of what constitutes suicidal risks, most supervised approaches for learning to automatically detect suicide-related activity in social media require a great deal of human labor to train. However, humans themselves have diverse or conflicting views on what constitutes suicidal thoughts. So how to obtain reliable gold standard labels is fundamentally challenging and, we hypothesize, depends largely on what is asked of the annotators and what slice of the data they label. We conducted multiple rounds of data labeling and collected annotations from crowdsourcing workers and domain experts. We aggregated the resulting labels in various ways to train a series of supervised models. Our preliminary evaluations show that using unanimously agreed labels from multiple annotators is helpful to achieve robust machine models.

Recent developments, particularly OpenAI's O1 model, have demonstrated the remarkable potential of Large Language Models (LLMs) for complex reasoning tasks. Through analysis of O1's outputs and provided sample Chain-of-Thought (CoT) demonstrations, we observe that it approaches problem-solving in a distinctly human-like manner, systematically brainstorming ideas, testing hypotheses, verifying results, and planning comprehensive solutions. These sophisticated reasoning capabilities remain notably absent in other state-of-the-art language models. In this paper, we hypothesize that this performance gap stems from the limited availability of high-quality reasoning process data in current training sets. We demonstrate that by constructing a specialized dataset focused on explicit problem-solving workflows ("worked solutions"), we can elicit substantially improved planning capabilities from existing models. Additionally, we propose the Reasoning Enhancement Loop (REL), a method for generating synthetic worked solutions.

In this paper, we propose to leverage the unique characteristics of dialogues sharing commonsense knowledge across participants, to resolve the difficulties in summarizing them. We present SICK, a framework that uses commonsense inferences as additional context. Compared to previous work that solely relies on the input dialogue, SICK uses an external knowledge model to generate a rich set of commonsense inferences and selects the most probable one with a similarity-based selection method. Built upon SICK, SICK++ utilizes commonsense as supervision, where the task of generating commonsense inferences is added upon summarizing the dialogue in a multi-task learning setting. Experimental results show that with injected commonsense knowledge, our framework generates more informative and consistent summaries than existing methods.

Even with various regulations in place across countries and social media platforms (Government of India, 2021; European Parliament and Council of the European Union, 2022, digital abusive speech remains a significant issue. One potential approach to address this challenge is automatic text detoxification, a text style transfer (TST) approach that transforms toxic language into a more neutral or non-toxic form. To date, the availability of parallel corpora for the text detoxification task (Logachevavet al., 2022; Atwell et al., 2022; Dementievavet al., 2024a) has proven to be crucial for state-of-the-art approaches. With this work, we extend parallel text detoxification corpus to new languages -- German, Chinese, Arabic, Hindi, and Amharic -- testing in the extensive multilingual setup TST baselines. Next, we conduct the first of its kind an automated, explainable analysis of the descriptive features of both toxic and non-toxic sentences, diving deeply into the nuances, similarities, and differences of toxicity and detoxification across 9 languages. Finally, based on the obtained insights, we experiment with a novel text detoxification method inspired by the Chain-of-Thoughts reasoning approach, enhancing the prompting process through clustering on relevant descriptive attributes.

Reasoning quality in large language models depends not only on producing correct answers but also on generating valid intermediate steps. We study this through multiple-choice question answering (MCQA), which provides a controlled setting with fixed answer options. Our analysis shows that when questions are effectively unsolvable for a model, spurious chains of thought (CoTs) are more likely to appear, leading to false positives. By estimating the solvability of each question, we uncover an intermediate regime where learning is most effective. Building on this insight, we adapt outcome-supervised reward models and reinforcement learning with group-relative advantage to incorporate solvability into their objectives. Across experiments on math and multimodal datasets, these modifications consistently yield higher rates of process-correct reasoning and, in reinforcement learning, improved answer accuracy as well. Our results highlight solvability as a key factor for reducing hallucinations and increasing reliability in CoT reasoning.

Human reasoning relies on constructing and manipulating mental models-simplified internal representations of situations that we use to understand and solve problems. Conceptual diagrams (for example, sketches drawn by humans to aid reasoning) externalize these mental models, abstracting irrelevant details to efficiently capture relational and spatial information. In contrast, Large Language Models (LLMs) and Large Multimodal Models (LMMs) predominantly reason through textual representations, limiting their effectiveness in complex multi-step combinatorial and planning tasks. In this paper, we propose a zero-shot fully automatic framework that enables LMMs to reason through multiple chains of self-generated intermediate conceptual diagrams, significantly enhancing their combinatorial planning capabilities. Our approach does not require any human initialization beyond a natural language description of the task. It integrates both textual and diagrammatic reasoning within an optimized graph-of-thought inference framework, enhanced by beam search and depth-wise backtracking. Evaluated on multiple challenging PDDL planning domains, our method substantially improves GPT-4o's performance (for example, from 35.5% to 90.2% in Blocksworld). On more difficult planning domains with solution depths up to 40, our approach outperforms even the o1-preview reasoning model (for example, over 13% improvement in Parking). These results highlight the value of conceptual diagrams as a complementary reasoning medium in LMMs.

Transparency in AI healthcare decision-making is crucial for building trust among AI and users. Incorporating reasoning capabilities enables Large Language Models (LLMs) to understand emotions in context, handle nuanced language, and infer unstated sentiments. In this work, we introduce a new task -- Sentiment Reasoning -- for both speech and text modalities, along with our proposed multimodal multitask framework and dataset. Sentiment Reasoning is an auxiliary task in sentiment analysis where the model predicts both the sentiment label and generates the rationale behind it based on the input transcript. Our study conducted on both human transcripts and Automatic Speech Recognition (ASR) transcripts shows that Sentiment Reasoning helps improve model transparency by providing rationale for model prediction with quality semantically comparable to humans while also improving model performance (1% increase in both accuracy and macro-F1) via rationale-augmented fine-tuning. Also, no significant difference in the semantic quality of generated rationales between human and ASR transcripts. All code, data (English-translated and Vietnamese) and models are published online: https://github.com/leduckhai/MultiMed.

Chain-of-thought reasoning, a cognitive process fundamental to human intelligence, has garnered significant attention in the realm of artificial intelligence and natural language processing. However, there still remains a lack of a comprehensive survey for this arena. To this end, we take the first step and present a thorough survey of this research field carefully and widely. We use X-of-Thought to refer to Chain-of-Thought in a broad sense. In detail, we systematically organize the current research according to the taxonomies of methods, including XoT construction, XoT structure variants, and enhanced XoT. Additionally, we describe XoT with frontier applications, covering planning, tool use, and distillation. Furthermore, we address challenges and discuss some future directions, including faithfulness, multi-modal, and theory. We hope this survey serves as a valuable resource for researchers seeking to innovate within the domain of chain-of-thought reasoning.

Automatic depression detection from conversational data has gained significant interest in recent years. The DAIC-WOZ dataset, interviews conducted by a human-controlled virtual agent, has been widely used for this task. Recent studies have reported enhanced performance when incorporating interviewer's prompts into the model. In this work, we hypothesize that this improvement might be mainly due to a bias present in these prompts, rather than the proposed architectures and methods. Through ablation experiments and qualitative analysis, we discover that models using interviewer's prompts learn to focus on a specific region of the interviews, where questions about past experiences with mental health issues are asked, and use them as discriminative shortcuts to detect depressed participants. In contrast, models using participant responses gather evidence from across the entire interview. Finally, to highlight the magnitude of this bias, we achieve a 0.90 F1 score by intentionally exploiting it, the highest result reported to date on this dataset using only textual information. Our findings underline the need for caution when incorporating interviewers' prompts into models, as they may inadvertently learn to exploit targeted prompts, rather than learning to characterize the language and behavior that are genuinely indicative of the patient's mental health condition.

Complex visual reasoning remains a key challenge today. Typically, the challenge is tackled using methodologies such as Chain of Thought (COT) and visual instruction tuning. However, how to organically combine these two methodologies for greater success remains unexplored. Also, issues like hallucinations and high training cost still need to be addressed. In this work, we devise an innovative multi-round training and reasoning framework suitable for lightweight Multimodal Large Language Models (MLLMs). Our self-questioning approach heuristically guides MLLMs to focus on visual clues relevant to the target problem, reducing hallucinations and enhancing the model's ability to describe fine-grained image details. This ultimately enables the model to perform well in complex visual reasoning and question-answering tasks. We have named this framework Socratic Questioning(SQ). To facilitate future research, we create a multimodal mini-dataset named CapQA, which includes 1k images of fine-grained activities, for visual instruction tuning and evaluation, our proposed SQ method leads to a 31.2% improvement in the hallucination score. Our extensive experiments on various benchmarks demonstrate SQ's remarkable capabilities in heuristic self-questioning, zero-shot visual reasoning and hallucination mitigation. Our model and code will be publicly available.

Recent advancements in reasoning-enhanced large language models (LLMs), such as DeepSeek-R1 and OpenAI-o3, have demonstrated significant progress. However, their application in professional medical contexts remains underexplored, particularly in evaluating the quality of their reasoning processes alongside final outputs. Here, we introduce MedR-Bench, a benchmarking dataset of 1,453 structured patient cases, annotated with reasoning references derived from clinical case reports. Spanning 13 body systems and 10 specialties, it includes both common and rare diseases. To comprehensively evaluate LLM performance, we propose a framework encompassing three critical examination recommendation, diagnostic decision-making, and treatment planning, simulating the entire patient care journey. To assess reasoning quality, we present the Reasoning Evaluator, a novel automated system that objectively scores free-text reasoning responses based on efficiency, actuality, and completeness using dynamic cross-referencing and evidence checks. Using this benchmark, we evaluate five state-of-the-art reasoning LLMs, including DeepSeek-R1, OpenAI-o3-mini, and Gemini-2.0-Flash Thinking, etc. Our results show that current LLMs achieve over 85% accuracy in relatively simple diagnostic tasks when provided with sufficient examination results. However, performance declines in more complex tasks, such as examination recommendation and treatment planning. While reasoning outputs are generally reliable, with factuality scores exceeding 90%, critical reasoning steps are frequently missed. These findings underscore both the progress and limitations of clinical LLMs. Notably, open-source models like DeepSeek-R1 are narrowing the gap with proprietary systems, highlighting their potential to drive accessible and equitable advancements in healthcare.

Recently, Chain-of-Thought (CoT) prompting has delivered success on complex reasoning tasks, which aims at designing a simple prompt like ``Let's think step by step'' or multiple in-context exemplars with well-designed rationales to elicit Large Language Models (LLMs) to generate intermediate reasoning steps. However, the generated rationales often come with mistakes, making unfactual and unfaithful reasoning chains. To mitigate this brittleness, we propose a novel Chain-of-Knowledge (CoK) prompting, where we aim at eliciting LLMs to generate explicit pieces of knowledge evidence in the form of structure triple. This is inspired by our human behaviors, i.e., we can draw a mind map or knowledge map as the reasoning evidence in the brain before answering a complex question. Benefiting from CoK, we additionally introduce a F^2-Verification method to estimate the reliability of the reasoning chains in terms of factuality and faithfulness. For the unreliable response, the wrong evidence can be indicated to prompt the LLM to rethink. Extensive experiments demonstrate that our method can further improve the performance of commonsense, factual, symbolic, and arithmetic reasoning tasks.

Large Language Models (LLMs) often exhibit hallucinations, generating factually incorrect or semantically irrelevant content in response to prompts. Chain-of-Thought (CoT) prompting can mitigate hallucinations by encouraging step-by-step reasoning, but its impact on hallucination detection remains underexplored. To bridge this gap, we conduct a systematic empirical evaluation. We begin with a pilot experiment, revealing that CoT reasoning significantly affects the LLM's internal states and token probability distributions. Building on this, we evaluate the impact of various CoT prompting methods on mainstream hallucination detection methods across both instruction-tuned and reasoning-oriented LLMs. Specifically, we examine three key dimensions: changes in hallucination score distributions, variations in detection accuracy, and shifts in detection confidence. Our findings show that while CoT prompting helps reduce hallucination frequency, it also tends to obscure critical signals used for detection, impairing the effectiveness of various detection methods. Our study highlights an overlooked trade-off in the use of reasoning. Code is publicly available at: https://github.com/ECNU-Text-Computing/cot-hallu-detect .

Reasoning is a cognitive process of using evidence to reach a sound conclusion. The reasoning capability is essential for large language models (LLMs) to serve as the brain of the artificial general intelligence agent. Recent studies reveal that fine-tuning LLMs on data with the chain of thought (COT) reasoning process can significantly enhance their reasoning capabilities. However, we find that the fine-tuned LLMs suffer from an Assessment Misalignment problem, i.e., they frequently assign higher scores to subpar COTs, leading to potential limitations in their reasoning abilities. To address this problem, we introduce an Alignment Fine-Tuning (AFT) paradigm, which involves three steps: 1) fine-tuning LLMs with COT training data; 2) generating multiple COT responses for each question, and categorizing them into positive and negative ones based on whether they achieve the correct answer; 3) calibrating the scores of positive and negative responses given by LLMs with a novel constraint alignment loss. Specifically, the constraint alignment loss has two objectives: a) Alignment, which guarantees that positive scores surpass negative scores to encourage answers with high-quality COTs; b) Constraint, which keeps the negative scores confined to a reasonable range to prevent the model degradation. Beyond just the binary positive and negative feedback, the constraint alignment loss can be seamlessly adapted to the ranking situations when ranking feedback is accessible. Furthermore, we also delve deeply into recent ranking-based alignment methods, such as DPO, RRHF, and PRO, and discover that the constraint, which has been overlooked by these approaches, is also crucial for their performance. Extensive experiments on four reasoning benchmarks with both binary and ranking feedback demonstrate the effectiveness of AFT.

Large reasoning models (LRMs) have demonstrated impressive performance across a range of reasoning tasks, yet little is known about their internal reasoning processes in multilingual settings. We begin with a critical question: {\it In which language do these models reason when solving problems presented in different languages?} Our findings reveal that, despite multilingual training, LRMs tend to default to reasoning in high-resource languages (e.g., English) at test time, regardless of the input language. When constrained to reason in the same language as the input, model performance declines, especially for low-resource languages. In contrast, reasoning in high-resource languages generally preserves performance. We conduct extensive evaluations across reasoning-intensive tasks (MMMLU, MATH-500) and non-reasoning benchmarks (CulturalBench, LMSYS-toxic), showing that the effect of language choice varies by task type: input-language reasoning degrades performance on reasoning tasks but benefits cultural tasks, while safety evaluations exhibit language-specific behavior. By exposing these linguistic biases in LRMs, our work highlights a critical step toward developing more equitable models that serve users across diverse linguistic backgrounds.

Recent large language models have shown promising capabilities in long-form reasoning, following structured chains of thought before arriving at a final answer. However, we observe that these reasoning paths tend to include substantial redundancy; analyzing attention patterns reveals that attention scores are widely scattered, particularly incorrect answers exhibit greater attention sparsity. In this paper, we demonstrate that deliberately removing this redundancy in the reasoning process significantly improves performance through clear thinking, i.e., removing distraction. Specifically, we systematically identify reasoning redundancy by measuring token-level attention scores to a special end-of-thinking token, which is appended to an explicit instruction inserted to conclude each intermediate reasoning step. Furthermore, we propose structure-aware pruning that prioritizes removing tokens in low-contributing reasoning chunks over individual tokens. After evicting redundant tokens, we remove the injected end-of-thinking instruction, then resume the reasoning generation. We demonstrate that our method significantly improves overall accuracy across reasoning-intensive benchmarks without any training involved. In particular, our method shows strong performance on challenging mathematical competition benchmarks such as AIME and AMC, where reasoning redundancy is more prevalent.

The rapid evolution of Large Language Models (LLMs) offers promising potential to alleviate the global scarcity of mental health professionals. However, LLMs' alignment with essential mental health counseling competencies remains understudied. We introduce CounselingBench, a novel NCMHCE-based benchmark evaluating LLMs across five key mental health counseling competencies. Testing 22 general-purpose and medical-finetuned LLMs, we find frontier models exceed minimum thresholds but fall short of expert-level performance, with significant variations: they excel in Intake, Assessment & Diagnosis yet struggle with Core Counseling Attributes and Professional Practice & Ethics. Medical LLMs surprisingly underperform generalist models accuracy-wise, while at the same time producing slightly higher-quality justifications but making more context-related errors. Our findings highlight the complexities of developing AI systems for mental health counseling, particularly for competencies requiring empathy and contextual understanding. We found that frontier LLMs perform at a level exceeding the minimal required level of aptitude for all key mental health counseling competencies, but fall short of expert-level performance, and that current medical LLMs do not significantly improve upon generalist models in mental health counseling competencies. This underscores the critical need for specialized, mental health counseling-specific fine-tuned LLMs that rigorously aligns with core competencies combined with appropriate human supervision before any responsible real-world deployment can be considered.

Recently, there have been notable advancements in large language models (LLMs), demonstrating their growing abilities in complex reasoning. However, existing research largely overlooks a thorough and systematic comparison of these models' reasoning processes and outputs, particularly regarding their self-reflection pattern (also termed "Aha moment") and the interconnections across diverse domains. This paper proposes a novel framework for analyzing the reasoning characteristics of four cutting-edge large reasoning models (GPT-o1, DeepSeek-R1, Kimi-k1.5, and Grok-3) using keywords statistic and LLM-as-a-judge paradigm. Our approach connects their internal thinking processes with their final outputs. A diverse dataset consists of real-world scenario-based questions covering logical deduction, causal inference, and multi-step problem-solving. Additionally, a set of metrics is put forward to assess both the coherence of reasoning and the accuracy of the outputs. The research results uncover various patterns of how these models balance exploration and exploitation, deal with problems, and reach conclusions during the reasoning process. Through quantitative and qualitative comparisons, disparities among these models are identified in aspects such as the depth of reasoning, the reliance on intermediate steps, and the degree of similarity between their thinking processes and output patterns and those of GPT-o1. This work offers valuable insights into the trade-off between computational efficiency and reasoning robustness and provides practical recommendations for enhancing model design and evaluation in practical applications. We publicly release our project at: https://github.com/ChangWenhan/FromThinking2Output

LLMs are typically trained to answer user questions or follow instructions similarly to how human experts respond. However, in the standard alignment framework they lack the basic ability of explicit thinking before answering. Thinking is important for complex questions that require reasoning and planning -- but can be applied to any task. We propose a training method for equipping existing LLMs with such thinking abilities for general instruction following without use of additional human data. We achieve this by an iterative search and optimization procedure that explores the space of possible thought generations, allowing the model to learn how to think without direct supervision. For each instruction, the thought candidates are scored using a judge model to evaluate their responses only, and then optimized via preference optimization. We show that this procedure leads to superior performance on AlpacaEval and Arena-Hard, and shows gains from thinking on non-reasoning categories such as marketing, health and general knowledge, in addition to more traditional reasoning & problem-solving tasks.