Daily Papers

As a key component in online marketing, uplift modeling aims to accurately capture the degree to which different treatments motivate different users, such as coupons or discounts, also known as the estimation of individual treatment effect (ITE). In an actual business scenario, the options for treatment may be numerous and complex, and there may be correlations between different treatments. In addition, each marketing instance may also have rich user and contextual features. However, existing methods still fall short in both fully exploiting treatment information and mining features that are sensitive to a particular treatment. In this paper, we propose an explicit feature interaction-aware uplift network (EFIN) to address these two problems. Our EFIN includes four customized modules: 1) a feature encoding module encodes not only the user and contextual features, but also the treatment features; 2) a self-interaction module aims to accurately model the user's natural response with all but the treatment features; 3) a treatment-aware interaction module accurately models the degree to which a particular treatment motivates a user through interactions between the treatment features and other features, i.e., ITE; and 4) an intervention constraint module is used to balance the ITE distribution of users between the control and treatment groups so that the model would still achieve a accurate uplift ranking on data collected from a non-random intervention marketing scenario. We conduct extensive experiments on two public datasets and one product dataset to verify the effectiveness of our EFIN. In addition, our EFIN has been deployed in a credit card bill payment scenario of a large online financial platform with a significant improvement.

Current mental-health conversational systems are usually based on fixed, generic dialogue patterns. This paper proposes an adaptive framework based on large language models that aims to personalize therapeutic interaction according to a user's psychological state, quantified with the Acceptance of Illness Scale (AIS). The framework defines three specialized agents, L, M, and H, each linked to a different level of illness acceptance, and adjusts conversational behavior over time using continuous feedback signals. The AIS-stratified architecture is treated as a diegetic prototype placed in a plausible near-future setting and examined through the method of design fiction. By embedding the architecture in narrative scenarios, the study explores how such agents might influence access to care and therapeutic relationship. The goal is to show how clinically informed personalization, technical feasibility, and speculative scenario analysis can together inform the responsible design of LLM-based companions for mental-health support.

Mental health has increasingly become a global issue that reveals the limitations of traditional conversational psychotherapy, constrained by location, time, expense, and privacy concerns. In response to these challenges, we introduce SoulSpeak, a Large Language Model (LLM)-enabled chatbot designed to democratize access to psychotherapy. SoulSpeak improves upon the capabilities of standard LLM-enabled chatbots by incorporating a novel dual-memory component that combines short-term and long-term context via Retrieval Augmented Generation (RAG) to offer personalized responses while ensuring the preservation of user privacy and intimacy through a dedicated privacy module. In addition, it leverages a counseling chat dataset of therapist-client interactions and various prompting techniques to align the generated responses with psychotherapeutic methods. We introduce two fine-tuned BERT models to evaluate the system against existing LLMs and human therapists: the Conversational Psychotherapy Preference Model (CPPM) to simulate human preference among responses and another to assess response relevance to user input. CPPM is useful for training and evaluating psychotherapy-focused language models independent from SoulSpeak, helping with the constrained resources available for psychotherapy. Furthermore, the effectiveness of the dual-memory component and the robustness of the privacy module are also examined. Our findings highlight the potential and challenge of enhancing mental health care by offering an alternative that combines the expertise of traditional therapy with the advantages of LLMs, providing a promising way to address the accessibility and personalization gap in current mental health services.

LLM-based simulated clients are increasingly used to train novice counselors, evaluate LLM therapists, and generate synthetic data. However, current simulators produce overly cooperative clients that disclose too readily, accept therapeutic reframes without resistance, and resolve core issues within a single session. We trace these issues to profiles that lack causal depth and behavioral mechanisms that treat all content as equally accessible. We present PatientAct, a framework for client simulation grounded in established clinical theories. Our profiles integrate the 5Ps clinical case formulation, providing causal depth without tying the design to any single therapeutic modality. During simulation, profiles include a dynamic memory layer in which items carry trust thresholds (e.g., symptoms are available early, whereas formative memories require a sustained therapeutic alliance). At each turn, the client's emotional reaction and behavior are modeled before generating a response. If the therapist approaches gated content, PatientAct expresses resistance in terms of quantity, content, and style rather than defaulting to cooperation or a single resistance pattern. We evaluate our framework on 40 clinical situations and demonstrate that it generates diverse profiles with high clinical plausibility. Moreover, PatientAct significantly outperforms the baselines, yielding substantial gains in resistance quality and behavioral realism. Our code and data will be publicly available via github.com/Sahandfer/PatientHub.

The rise of large language models (LLMs) has revolutionized user interactions with knowledge-based systems, enabling chatbots to synthesize vast amounts of information and assist with complex, exploratory tasks. However, LLM-based chatbots often struggle to provide personalized support, particularly when users start with vague queries or lack sufficient contextual information. This paper introduces the Collaborative Assistant for Personalized Exploration (CARE), a system designed to enhance personalization in exploratory tasks by combining a multi-agent LLM framework with a structured user interface. CARE's interface consists of a Chat Panel, Solution Panel, and Needs Panel, enabling iterative query refinement and dynamic solution generation. The multi-agent framework collaborates to identify both explicit and implicit user needs, delivering tailored, actionable solutions. In a within-subject user study with 22 participants, CARE was consistently preferred over a baseline LLM chatbot, with users praising its ability to reduce cognitive load, inspire creativity, and provide more tailored solutions. Our findings highlight CARE's potential to transform LLM-based systems from passive information retrievers to proactive partners in personalized problem-solving and exploration.

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

Conversational agents are increasingly used to address emotional needs on top of information needs. One use case of increasing interest are counselling-style mental health and behaviour change interventions, with large language model (LLM)-based approaches becoming more popular. Research in this context so far has been largely system-focused, foregoing the aspect of user behaviour and the impact this can have on LLM-generated texts. To address this issue, we share a dataset containing text-based user interactions related to behaviour change with two GPT-4-based conversational agents collected in a preregistered user study. This dataset includes conversation data, user language analysis, perception measures, and user feedback for LLM-generated turns, and can offer valuable insights to inform the design of such systems based on real interactions.

As a key component in boosting online user growth, uplift modeling aims to measure individual user responses (e.g., whether to play the game) to various treatments, such as gaming bonuses, thereby enhancing business outcomes. However, previous research typically considers a single-task, single-treatment setting, where only one treatment exists and the overall treatment effect is measured by a single type of user response. In this paper, we propose a Multi-Treatment Multi-Task (MTMT) uplift network to estimate treatment effects in a multi-task scenario. We identify the multi-treatment problem as a causal inference problem with a tiered response, comprising a base effect (from offering a treatment) and an incremental effect (from offering a specific type of treatment), where the base effect can be numerically much larger than the incremental effect. Specifically, MTMT separately encodes user features and treatments. The user feature encoder uses a multi-gate mixture of experts (MMOE) network to encode relevant user features, explicitly learning inter-task relations. The resultant embeddings are used to measure natural responses per task. Furthermore, we introduce a treatment-user feature interaction module to model correlations between each treatment and user feature. Consequently, we separately measure the base and incremental treatment effect for each task based on the produced treatment-aware representations. Experimental results based on an offline public dataset and an online proprietary dataset demonstrate the effectiveness of MTMT in single/multi-treatment and single/multi-task settings. Additionally, MTMT has been deployed in our gaming platform to improve user experience.

Recent advances in psychotherapy have focused on treatment personalization, such as by selecting treatment modules based on personalized networks. However, estimating personalized networks typically requires intensive longitudinal data, which is not always feasible. A solution to facilitate scalability of network-driven treatment personalization is leveraging LLMs. In this study, we present an end-to-end pipeline for automatically generating client networks from 77 therapy transcripts to support case conceptualization and treatment planning. We annotated 3364 psychological processes and their corresponding dimensions in therapy transcripts. Using these data, we applied in-context learning to jointly identify psychological processes and their dimensions. The method achieved high performance even with a few training examples. To organize the processes into networks, we introduced a two-step method that grouped them into clinically meaningful clusters. We then generated explanation-augmented relationships between clusters. Experts found that networks produced by our multi-step approach outperformed those built with direct prompting for clinical utility and interpretability, with up to 90% preferring our approach. In addition, the networks were rated favorably by experts, with scores for clinical relevance, novelty, and usefulness ranging from 72-75%. Our findings provide a proof of concept for using LLMs to create clinically relevant networks from therapy transcripts. Advantages of our approach include bottom-up case conceptualization from client utterances in therapy sessions and identification of latent themes. Networks generated from our pipeline may be used in clinical settings and supervision and training. Future research should examine whether these networks improve treatment outcomes relative to other methods of treatment personalization, including statistically estimated networks.

Access to mental healthcare is increasingly strained by workforce shortages and rising demand, motivating the development of intelligent systems that can support mental healthcare experts. We introduce coTherapist, a unified framework utilizing a small language model to emulate core therapeutic competencies through domain-specific fine-tuning, retrieval augmentation, and agentic reasoning. Evaluation on clinical queries demonstrates that coTherapist generates more relevant and clinically grounded responses than contemporary baselines. Using our novel T-BARS rubric and psychometric profiling, we confirm coTherapist exhibits high empathy and therapist-consistent personality traits. Furthermore, human evaluation by domain experts validates that coTherapist delivers accurate, trustworthy, and safe responses. coTherapist was deployed and tested by clinical experts. Collectively, these findings demonstrate that small models can be engineered to exhibit expert-like behavior, offering a scalable pathway for digital mental health tools.

Clinical trials are crucial for drug development but are time consuming, expensive, and often burdensome on patients. More importantly, clinical trials face uncertain outcomes due to issues with efficacy, safety, or problems with patient recruitment. If we were better at predicting the results of clinical trials, we could avoid having to run trials that will inevitably fail more resources could be devoted to trials that are likely to succeed. In this paper, we propose Hierarchical INteraction Network (HINT) for more general, clinical trial outcome predictions for all diseases based on a comprehensive and diverse set of web data including molecule information of the drugs, target disease information, trial protocol and biomedical knowledge. HINT first encode these multi-modal data into latent embeddings, where an imputation module is designed to handle missing data. Next, these embeddings will be fed into the knowledge embedding module to generate knowledge embeddings that are pretrained using external knowledge on pharmaco-kinetic properties and trial risk from the web. Then the interaction graph module will connect all the embedding via domain knowledge to fully capture various trial components and their complex relations as well as their influences on trial outcomes. Finally, HINT learns a dynamic attentive graph neural network to predict trial outcome. Comprehensive experimental results show that HINT achieves strong predictive performance, obtaining 0.772, 0.607, 0.623, 0.703 on PR-AUC for Phase I, II, III, and indication outcome prediction, respectively. It also consistently outperforms the best baseline method by up to 12.4\% on PR-AUC.

Millions of users come to online peer counseling platforms to seek support on diverse topics ranging from relationship stress to anxiety. However, studies show that online peer support groups are not always as effective as expected largely due to users' negative experiences with unhelpful counselors. Peer counselors are key to the success of online peer counseling platforms, but most of them often do not have systematic ways to receive guidelines or supervision. In this work, we introduce CARE: an interactive AI-based tool to empower peer counselors through automatic suggestion generation. During the practical training stage, CARE helps diagnose which specific counseling strategies are most suitable in the given context and provides tailored example responses as suggestions. Counselors can choose to select, modify, or ignore any suggestion before replying to the support seeker. Building upon the Motivational Interviewing framework, CARE utilizes large-scale counseling conversation data together with advanced natural language generation techniques to achieve these functionalities. We demonstrate the efficacy of CARE by performing both quantitative evaluations and qualitative user studies through simulated chats and semi-structured interviews. We also find that CARE especially helps novice counselors respond better in challenging situations.

The integration of conversational artificial intelligence (AI) into mental health care promises a new horizon for therapist-client interactions, aiming to closely emulate the depth and nuance of human conversations. Despite the potential, the current landscape of conversational AI is markedly limited by its reliance on single-modal data, constraining the systems' ability to empathize and provide effective emotional support. This limitation stems from a paucity of resources that encapsulate the multimodal nature of human communication essential for therapeutic counseling. To address this gap, we introduce the Multimodal Emotional Support Conversation (MESC) dataset, a first-of-its-kind resource enriched with comprehensive annotations across text, audio, and video modalities. This dataset captures the intricate interplay of user emotions, system strategies, system emotion, and system responses, setting a new precedent in the field. Leveraging the MESC dataset, we propose a general Sequential Multimodal Emotional Support framework (SMES) grounded in Therapeutic Skills Theory. Tailored for multimodal dialogue systems, the SMES framework incorporates an LLM-based reasoning model that sequentially generates user emotion recognition, system strategy prediction, system emotion prediction, and response generation. Our rigorous evaluations demonstrate that this framework significantly enhances the capability of AI systems to mimic therapist behaviors with heightened empathy and strategic responsiveness. By integrating multimodal data in this innovative manner, we bridge the critical gap between emotion recognition and emotional support, marking a significant advancement in conversational AI for mental health support.

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.

Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PatientSim, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PatientSim operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations. We evaluated eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3, was validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PatientSim provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare.

Due to the lack of human resources for mental health support, there is an increasing demand for employing conversational agents for support. Recent work has demonstrated the effectiveness of dialogue models in providing emotional support. As previous studies have demonstrated that seekers' persona is an important factor for effective support, we investigate whether there are benefits to modeling such information in dialogue models for support. In this paper, our empirical analysis verifies that persona has an important impact on emotional support. Therefore, we propose a framework for dynamically inferring and modeling seekers' persona. We first train a model for inferring the seeker's persona from the conversation history. Accordingly, we propose PAL, a model that leverages persona information and, in conjunction with our strategy-based controllable generation method, provides personalized emotional support. Automatic and manual evaluations demonstrate that PAL achieves state-of-the-art results, outperforming the baselines on the studied benchmark. Our code and data are publicly available at https://github.com/chengjl19/PAL.

Interventions on model-internal states are fundamental operations in many areas of AI, including model editing, steering, robustness, and interpretability. To facilitate such research, we introduce pyvene, an open-source Python library that supports customizable interventions on a range of different PyTorch modules. pyvene supports complex intervention schemes with an intuitive configuration format, and its interventions can be static or include trainable parameters. We show how pyvene provides a unified and extensible framework for performing interventions on neural models and sharing the intervened upon models with others. We illustrate the power of the library via interpretability analyses using causal abstraction and knowledge localization. We publish our library through Python Package Index (PyPI) and provide code, documentation, and tutorials at https://github.com/stanfordnlp/pyvene.

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 psychotherapy, therapeutic outcome assessment, or treatment outcome evaluation, is essential for enhancing mental health care by systematically evaluating therapeutic processes and outcomes. Existing large language model approaches often focus on therapist-centered, single-session evaluations, neglecting the client's subjective experience and longitudinal progress across multiple sessions. To address these limitations, we propose IPAEval, a client-Informed Psychological Assessment-based Evaluation framework that automates treatment outcome evaluations from the client's perspective using clinical interviews. IPAEval integrates cross-session client-contextual assessment and session-focused client-dynamics assessment to provide a comprehensive understanding of therapeutic progress. Experiments on our newly developed TheraPhase dataset demonstrate that IPAEval effectively tracks symptom severity and treatment outcomes over multiple sessions, outperforming previous single-session models and validating the benefits of items-aware reasoning mechanisms.

Large language models (LLMs) have demonstrated growing competence in web page generation. However, existing text-driven approaches rely on complex prompts that impose substantial demands on users and offer limited expressivity for page layout and cross-page visual coherence. Image-driven paradigms, which take UI screenshots as input, align more closely with real development workflows. However, current benchmarks focus primarily on visual fidelity and lack a systematic evaluation of the interaction capabilities in generated artifacts. To address this gap, we introduce UI2App, the first benchmark targeting interaction inference, the ability to recover application behavior from screenshots alone, without any textual or behavioral guidance. UI2App comprises 327 screenshots grouped into 45 state-coherent screenshot sets for runnable multi-route web applications. We design an end-to-end pipeline that evaluates each artifact along four dimensions: executability, navigation reachability, visual fidelity, and interaction inference. The interaction metric (IIS) assesses inferred interactions by functional correctness and state-management complexity, crediting any valid implementation rather than matching a single reference. Experiments on six frontier vision-language models reveal a marked capability mismatch between visual reconstruction and interaction realization: the visual-fidelity leader scores only 7.5 on IIS, ranking fourth and trailing the IIS leader by 5.2x. High-complexity interactions such as cross-page state remain a pervasive bottleneck, with half of the evaluated models scoring exactly zero on this dimension. Overall, the results indicate that inferring complete interaction behavior from static screenshots remains a key challenge for models.

Large language models (LLMs) have evolved into interactive agents that collaborate with users in real-world tasks. Effective collaboration in such settings increasingly depends on understanding the user beyond what is explicitly stated, as user intent is often reflected in fragmented daily interactions and requires both personalized modeling and proactive interaction. However, existing agent benchmarks primarily evaluate reasoning and tool use, largely overlooking the challenges of inferring and leveraging user preferences in realistic scenarios. To address this gap, we introduce VitaBench 2.0, a benchmark for evaluating personalized and proactive agent behavior in long-term user interactions. In VitaBench 2.0, tasks are organized as temporally ordered sequences for individual users, where preferences are embedded in fragmented and heterogeneous interactions. Successful completion of tasks requires the agent to continuously extract, utilize, and update user preferences from these interactions. We further evaluate proactiveness through tasks that require agents to recognize missing information and actively acquire it from users or environments before making decisions. To support systematic analysis, we provide an extensible memory interface that enables controlled comparison across different memory architectures. We benchmark a diverse set of frontier proprietary and open-source LLMs. Results show that real-world personalization remains highly challenging even for state-of-the-art models, revealing a substantial gap between current capabilities and practical requirements. Extensive analysis further reveals the failure modes and capability bottlenecks of current agents in real-world personalized decision-making, providing insights for future model improvements.

Large language models (LLMs) chatbots like ChatGPT are increasingly used for mental health support. They offer accessible, therapeutic support but also raise concerns about misinformation, over-reliance, and risks in high-stakes contexts of mental health. We crowdsource large-scale users' posts from six major social media platforms to examine how people discuss their interactions with LLM chatbots across different mental health conditions. Through an LLM-assisted pipeline grounded in Value-Sensitive Design (VSD), we mapped the relationships across user-reported sentiments, mental health conditions, perspectives, and values. Our results reveal that the use of LLM chatbots is condition-specific. Users with neurodivergent conditions (e.g., ADHD, ASD) report strong positive sentiments and instrumental or appraisal support, whereas higher-risk disorders (e.g., schizophrenia, bipolar disorder) show more negative sentiments. We further uncover how user perspectives co-occur with underlying values, such as identity, autonomy, and privacy. Finally, we discuss shifting from "one-size-fits-all" chatbot design toward condition-specific, value-sensitive LLM design.

Deep research agents powered by Large Language Models (LLMs) can perform multi-step reasoning, web exploration, and long-form report generation. However, most existing systems operate in an autonomous manner, assuming fully specified user intent and evaluating only final outputs. In practice, research goals are often underspecified and evolve during exploration, making sustained interaction essential for robust alignment. Despite its importance, interaction remains largely invisible to existing deep research benchmarks, which neither model dynamic user feedback nor quantify its costs. We introduce IDRBench, the first benchmark for systematically evaluating interactive deep research. IDRBench combines a modular multi-agent research framework with on-demand interaction, a scalable reference-grounded user simulator, and an interaction-aware evaluation suite that jointly measures interaction benefits (quality and alignment) and costs (turns and tokens). Experiments across seven state-of-the-art LLMs show that interaction consistently improves research quality and robustness, often outweighing differences in model capacity, while revealing substantial trade-offs in interaction efficiency.

Virtual counselors powered by large language models (LLMs) aim to create interactive support systems that effectively assist clients struggling with mental health challenges. To replicate counselor-client conversations, researchers have built an online mental health platform that allows professional counselors to provide clients with text-based counseling services for about an hour per session. Notwithstanding its effectiveness, challenges exist as human annotation is time-consuming, cost-intensive, privacy-protected, and not scalable. To address this issue and investigate the applicability of LLMs in psychological counseling conversation simulation, we propose a framework that employs two LLMs via role-playing for simulating counselor-client interactions. Our framework involves two LLMs, one acting as a client equipped with a specific and real-life user profile and the other playing the role of an experienced counselor, generating professional responses using integrative therapy techniques. We implement both the counselor and the client by zero-shot prompting the GPT-4 model. In order to assess the effectiveness of LLMs in simulating counselor-client interactions and understand the disparities between LLM- and human-generated conversations, we evaluate the synthetic data from various perspectives. We begin by assessing the client's performance through automatic evaluations. Next, we analyze and compare the disparities between dialogues generated by the LLM and those generated by professional counselors. Furthermore, we conduct extensive experiments to thoroughly examine the performance of our LLM-based counselor trained with synthetic interactive dialogues by benchmarking against state-of-the-art models for mental health.

People experiencing severe distress increasingly use Large Language Model (LLM) chatbots as mental health support tools. Discussions on social media have described how engagements were lifesaving for some, but evidence suggests that general-purpose LLM chatbots also have notable risks that could endanger the welfare of users if not designed responsibly. In this study, we investigate the lived experiences of people who have used LLM chatbots for mental health support. We build on interviews with 21 individuals from globally diverse backgrounds to analyze how users create unique support roles for their chatbots, fill in gaps in everyday care, and navigate associated cultural limitations when seeking support from chatbots. We ground our analysis in psychotherapy literature around effective support, and introduce the concept of therapeutic alignment, or aligning AI with therapeutic values for mental health contexts. Our study offers recommendations for how designers can approach the ethical and effective use of LLM chatbots and other AI mental health support tools in mental health care.

Social interactions are fundamental to well-being, yet automatically detecting them in daily life-particularly using wearables-remains underexplored. Most existing systems are evaluated in controlled settings, focus primarily on in-person interactions, or rely on restrictive assumptions (e.g., requiring multiple speakers within fixed temporal windows), limiting generalizability to real-world use. We present an on-watch interaction detection system designed to capture diverse interactions in naturalistic settings. A core component is a foreground speech detector trained on a public dataset. Evaluated on over 100,000 labeled foreground speech and background sound instances, the detector achieves a balanced accuracy of 85.51%, outperforming prior work by 5.11%. We evaluated the system in a real-world deployment (N=38), with over 900 hours of total smartwatch wear time. The system detected 1,691 interactions, 77.28% were confirmed via participant self-report, with durations ranging from under one minute to over one hour. Among correct detections, 81.45% were in-person, 15.7% virtual, and 1.85% hybrid. Leveraging participant-labeled data, we further developed a multimodal model achieving a balanced accuracy of 90.36% and a sensitivity of 91.17% on 33,698 labeled 15-second windows. These results demonstrate the feasibility of real-world interaction sensing and open the door to adaptive, context-aware systems responding to users' dynamic social environments.

Can small language models with 0.5B to 5B parameters meaningfully engage in trauma-informed, empathetic dialogue for individuals with PTSD? We address this question by introducing TIDE, a dataset of 10,000 two-turn dialogues spanning 500 diverse PTSD client personas and grounded in a three-factor empathy model: emotion recognition, distress normalization, and supportive reflection. All scenarios and reference responses were reviewed for realism and trauma sensitivity by a clinical psychologist specializing in PTSD. We evaluate eight small language models before and after fine-tuning, comparing their outputs to a frontier model (Claude Sonnet 3.5). Our IRB-approved human evaluation and automatic metrics show that fine-tuning generally improves perceived empathy, but gains are highly scenario- and user-dependent, with smaller models facing an empathy ceiling. Demographic analysis shows older adults value distress validation and graduate-educated users prefer nuanced replies, while gender effects are minimal. We highlight the limitations of automatic metrics and the need for context- and user-aware system design. Our findings, along with the planned release of TIDE, provide a foundation for building safe, resource-efficient, and ethically sound empathetic AI to supplement, not replace, clinical mental health care.

Personalized interaction is highly valued by parents in their story-reading activities with children. While AI-empowered story-reading tools have been increasingly used, their abilities to support personalized interaction with children are still limited. Recent advances in large language models (LLMs) show promise in facilitating personalized interactions, but little is known about how to effectively and appropriately use LLMs to enhance children's personalized story-reading experiences. This work explores this question through a design-based study. Drawing on a formative study, we designed and developed StoryMate, an LLM-empowered personalized interactive story-reading tool for children, following an empirical study with children, parents, and education experts. Our participants valued the personalized features in StoryMate, and also highlighted the need to support personalized content, guiding mechanisms, reading context variations, and interactive interfaces. Based on these findings, we propose a series of design recommendations for better using LLMs to empower children's personalized story reading and interaction.

CleanS2S is a framework for human-like speech-to-speech interaction that advances conversational AI through single-file implementation and proactive dialogue capabilities. Our system integrates automatic speech recognition, large language models, and text-to-speech synthesis into a unified pipeline with real-time interruption handling, achieving low transition latency through full-duplex websocket connections and non-blocking I/O. Beyond conventional chatbot paradigms, we pioneer a proactive interaction mechanism, which combines memory systems with Subjective Action Judgement module, enabling five human-like response strategies: interruption, refusal, deflection, silence, and standard response. The memory module dynamically aggregates historical, and contextual data to inform interaction decisions. This approach breaks the rigid turn-based convention by allowing system-initiated dialog control and context-aware response selection. And we propose Action Judgement SFT that assesses input streams for responses strategies. The framework's single-file implementation with atomic configurations offers researchers unprecedented transparency and extensibility for interaction agents. The code of CleanS2S is released at \https://github.com/opendilab/CleanS2S.

Information workers' productivity is significantly influenced by their cognitive states and physiological responses. AI assistants such as ChatGPT, Copilot, and others have become integral components of knowledge-intensive workplaces. These AI assistants utilize pre-defined user preferences and chat interaction histories, thus confining themselves to reactive exchanges, lacking sufficient adaptability. Consequently, they fail to cater to individual user preferences and are unable to adapt to their psychophysiological states, diminishing potential productivity gains. To bridge this gap, we introduce AwareLLM, a novel multimodal framework that integrates egocentric vision, pupillometry, eye-gaze tracking, posture detection, heart activity, and the inferencing capabilities of large language models (LLMs) to create a proactive and context-aware ecosystem. AwareLLM dynamically adapts to users' psychophysiological states while analyzing temporal patterns and behavioral tendencies to provide personalized and timely interventions. We evaluated AwareLLM through a user study with 20 participants, comparing it to a standard LLM assistant across multiple tasks. Our results show statistically significant improvements in task performance, along with reductions in cognitive fatigue and mental demand. Participants described AwareLLM's personalized interventions as timely and relevant, helping them boost their confidence and deepen engagement with their work. AwareLLM opens new avenues for Human-AI collaboration where technology adapts to our needs rather than us adhering to technological constraints.

Open Vocabulary Human-Object Interaction (HOI) detection aims to detect interactions between humans and objects while generalizing to novel interaction classes beyond the training set. Current methods often rely on Vision and Language Models (VLMs) but face challenges due to suboptimal image encoders, as image-level pre-training does not align well with the fine-grained region-level interaction detection required for HOI. Additionally, effectively encoding textual descriptions of visual appearances remains difficult, limiting the model's ability to capture detailed HOI relationships. To address these issues, we propose INteraction-aware Prompting with Concept Calibration (INP-CC), an end-to-end open-vocabulary HOI detector that integrates interaction-aware prompts and concept calibration. Specifically, we propose an interaction-aware prompt generator that dynamically generates a compact set of prompts based on the input scene, enabling selective sharing among similar interactions. This approach directs the model's attention to key interaction patterns rather than generic image-level semantics, enhancing HOI detection. Furthermore, we refine HOI concept representations through language model-guided calibration, which helps distinguish diverse HOI concepts by investigating visual similarities across categories. A negative sampling strategy is also employed to improve inter-modal similarity modeling, enabling the model to better differentiate visually similar but semantically distinct actions. Extensive experimental results demonstrate that INP-CC significantly outperforms state-of-the-art models on the SWIG-HOI and HICO-DET datasets. Code is available at https://github.com/ltttpku/INP-CC.

In the field of human-object interaction (HOI), detection and generation are two dual tasks that have traditionally been addressed separately, hindering the development of comprehensive interaction understanding. To address this, we propose UniHOI, which jointly models HOI detection and generation via a unified token space, thereby effectively promoting knowledge sharing and enhancing generalization. Specifically, we introduce a symmetric interaction-aware attention module and a unified semi-supervised learning paradigm, enabling effective bidirectional mapping between images and interaction semantics even under limited annotations. Extensive experiments demonstrate that UniHOI achieves state-of-the-art performance in both HOI detection and generation. Specifically, UniHOI improves accuracy by 4.9% on long-tailed HOI detection and boosts interaction metrics by 42.0% on open-vocabulary generation tasks.

Generating talking avatars is a fundamental task in video generation. Although existing methods can generate full-body talking avatars with simple human motion, extending this task to grounded human-object interaction (GHOI) remains an open challenge, requiring the avatar to perform text-aligned interactions with surrounding objects. This challenge stems from the need for environmental perception and the control-quality dilemma in GHOI generation. To address this, we propose a novel dual-stream framework, InteractAvatar, which decouples perception and planning from video synthesis for grounded human-object interaction. Leveraging detection to enhance environmental perception, we introduce a Perception and Interaction Module (PIM) to generate text-aligned interaction motions. Additionally, an Audio-Interaction Aware Generation Module (AIM) is proposed to synthesize vivid talking avatars performing object interactions. With a specially designed motion-to-video aligner, PIM and AIM share a similar network structure and enable parallel co-generation of motions and plausible videos, effectively mitigating the control-quality dilemma. Finally, we establish a benchmark, GroundedInter, for evaluating GHOI video generation. Extensive experiments and comparisons demonstrate the effectiveness of our method in generating grounded human-object interactions for talking avatars. Project page: https://interactavatar.github.io

Identifying effective interventions from the scientific literature is challenging due to the high volume of publications, specialized terminology, and inconsistent reporting formats, making manual curation laborious and prone to oversight. To address this challenge, this paper proposes a novel framework leveraging large language models (LLMs), which integrates a progressive ontology prompting (POP) algorithm with a dual-agent system, named LLM-Duo. On the one hand, the POP algorithm conducts a prioritized breadth-first search (BFS) across a predefined ontology, generating structured prompt templates and action sequences to guide the automatic annotation process. On the other hand, the LLM-Duo system features two specialized LLM agents, an explorer and an evaluator, working collaboratively and adversarially to continuously refine annotation quality. We showcase the real-world applicability of our framework through a case study focused on speech-language intervention discovery. Experimental results show that our approach surpasses advanced baselines, achieving more accurate and comprehensive annotations through a fully automated process. Our approach successfully identified 2,421 interventions from a corpus of 64,177 research articles in the speech-language pathology domain, culminating in the creation of a publicly accessible intervention knowledge base with great potential to benefit the speech-language pathology community.

Evaluating persona-aligned empathy in LLM-based dialogue agents remains challenging. User states are latent, feedback is sparse and difficult to verify in situ, and seemingly supportive turns can still accumulate into trajectories that drift from persona-specific needs. We introduce EMPA, a process-oriented framework that evaluates persona-aligned support as sustained intervention rather than isolated replies. EMPA distills real interactions into controllable, psychologically grounded scenarios, couples them with an open-ended multi-agent sandbox that exposes strategic adaptation and failure modes, and scores trajectories in a latent psychological space by directional alignment, cumulative impact, and stability. The resulting signals and metrics support reproducible comparison and optimization of long-horizon empathic behavior, and they extend to other agent settings shaped by latent dynamics and weak, hard-to-verify feedback.

Mental manipulation severely undermines mental wellness by covertly and negatively distorting decision-making. While there is an increasing interest in mental health care within the natural language processing community, progress in tackling manipulation remains limited due to the complexity of detecting subtle, covert tactics in conversations. In this paper, we propose Intent-Aware Prompting (IAP), a novel approach for detecting mental manipulations using large language models (LLMs), providing a deeper understanding of manipulative tactics by capturing the underlying intents of participants. Experimental results on the MentalManip dataset demonstrate superior effectiveness of IAP against other advanced prompting strategies. Notably, our approach substantially reduces false negatives, helping detect more instances of mental manipulation with minimal misjudgment of positive cases. The code of this paper is available at https://github.com/Anton-Jiayuan-MA/Manip-IAP.

Seeking dietary guidance often requires navigating complex professional knowledge while accommodating individual health conditions. Knowledge Graphs (KGs) offer structured and interpretable nutritional information, whereas Large Language Models (LLMs) naturally facilitate conversational recommendation delivery. In this paper, we present HealthGenie, an interactive system that combines the strengths of LLMs and KGs to provide personalized dietary recommendations along with hierarchical information visualization for a quick and intuitive overview. Upon receiving a user query, HealthGenie performs query refinement and retrieves relevant information from a pre-built KG. The system then visualizes and highlights pertinent information, organized by defined categories, while offering detailed, explainable recommendation rationales. Users can further tailor these recommendations by adjusting preferences interactively. Our evaluation, comprising a within-subject comparative experiment and an open-ended discussion, demonstrates that HealthGenie effectively supports users in obtaining personalized dietary guidance based on their health conditions while reducing interaction effort and cognitive load. These findings highlight the potential of LLM-KG integration in supporting decision-making through explainable and visualized information. We examine the system's usefulness and effectiveness with an N=12 within-subject study and provide design considerations for future systems that integrate conversational LLM and KG.

Current generative AI models like ChatGPT, Claude, and Gemini are widely used for knowledge dissemination, task decomposition, and creative thinking. However, their linear interaction methods often force users to repeatedly compare and copy contextual information when handling complex tasks, increasing cognitive load and operational costs. Moreover, the ambiguity in model responses requires users to refine and simplify the information further. To address these issues, we developed "Mindalogue", a system using a non-linear interaction model based on "nodes + canvas" to enhance user efficiency and freedom while generating structured responses. A formative study with 11 users informed the design of Mindalogue, which was then evaluated through a study with 16 participants. The results showed that Mindalogue significantly reduced task steps and improved users' comprehension of complex information. This study highlights the potential of non-linear interaction in improving AI tool efficiency and user experience in the HCI field.

Language model users often embed personal and social context in their questions. The asker's role -- implicit in how the question is framed -- creates specific needs for an appropriate response. However, most evaluations, while capturing the model's capability to respond, often ignore who is asking. This gap is especially critical in stigmatized domains such as opioid use disorder (OUD), where accounting for users' contexts is essential to provide accessible, stigma-free responses. We propose CoRUS (COmmunity-driven Roles for User-centric Question Simulation), a framework for simulating role-based questions. Drawing on role theory and posts from an online OUD recovery community (r/OpiatesRecovery), we first build a taxonomy of asker roles -- patients, caregivers, practitioners. Next, we use it to simulate 15,321 questions that embed each role's goals, behaviors, and experiences. Our evaluations show that these questions are both highly believable and comparable to real-world data. When used to evaluate five LLMs, for the same question but differing roles, we find systematic differences: vulnerable roles, such as patients and caregivers, elicit more supportive responses (+17%) and reduced knowledge content (-19%) in comparison to practitioners. Our work demonstrates how implicitly signaling a user's role shapes model responses, and provides a methodology for role-informed evaluation of conversational AI.

Recent advancements in large language models (LLMs) have revolutionized their ability to handle single-turn tasks, yet real-world applications demand sophisticated multi-turn interactions. This survey provides a comprehensive review of recent advancements in evaluating and enhancing multi-turn interactions in LLMs. Focusing on task-specific scenarios, from instruction following in diverse domains such as math and coding to complex conversational engagements in roleplay, healthcare, education, and even adversarial jailbreak settings, we systematically examine the challenges of maintaining context, coherence, fairness, and responsiveness over prolonged dialogues. The paper organizes current benchmarks and datasets into coherent categories that reflect the evolving landscape of multi-turn dialogue evaluation. In addition, we review a range of enhancement methodologies under multi-turn settings, including model-centric strategies (contextual learning, supervised fine-tuning, reinforcement learning, and new architectures), external integration approaches (memory-augmented, retrieval-based methods, and knowledge graph), and agent-based techniques for collaborative interactions. Finally, we discuss open challenges and propose future directions for research to further advance the robustness and effectiveness of multi-turn interactions in LLMs. Related resources and papers are available at https://github.com/yubol-cmu/Awesome-Multi-Turn-LLMs.

Large language models (LLMs) are increasingly explored as scalable tools for mental health counseling, yet evaluating their safety remains challenging due to the interactional and context-dependent nature of clinical harm. Existing evaluation frameworks predominantly assess isolated responses using coarse-grained taxonomies or static datasets, limiting their ability to diagnose how harms emerge and accumulate over multi-turn counseling interactions. In this work, we introduce R-MHSafe, a role-aware mental health safety taxonomy that characterizes clinically significant harm in terms of the interactional roles an AI counselor adopts, including perpetrator, instigator, facilitator, or enabler, combined with clinically grounded harm categories. Then, we propose MHSafeEval, a closed-loop, agent-based evaluation framework that formulates safety assessment as trajectory-level discovery of harm through adversarial multi-turn interactions, guided by role-aware modeling. Using R-MHSafe and MHSafeEval, we conduct a large-scale evaluation across state-of-the-art LLMs. Our results reveal substantial role-dependent and cumulative safety failures that are systematically missed by existing static benchmarks, and show that our framework significantly improves failure-mode coverage and diagnostic granularity.

Large Language Models (LLMs) have demonstrated remarkable capabilities in understanding and generating human-like text, yet they largely operate as reactive agents, responding only when directly prompted. This passivity creates an "awareness gap," limiting their potential as truly collaborative partners in dynamic human discussions. We introduce DiscussLLM, a framework designed to bridge this gap by training models to proactively decide not just what to say, but critically, when to speak. Our primary contribution is a scalable two-stage data generation pipeline that synthesizes a large-scale dataset of realistic multi-turn human discussions. Each discussion is annotated with one of five intervention types (e.g., Factual Correction, Concept Definition) and contains an explicit conversational trigger where an AI intervention adds value. By training models to predict a special silent token when no intervention is needed, they learn to remain quiet until a helpful contribution can be made. We explore two architectural baselines: an integrated end-to-end model and a decoupled classifier-generator system optimized for low-latency inference. We evaluate these models on their ability to accurately time interventions and generate helpful responses, paving the way for more situationally aware and proactive conversational AI.

There are growing concerns about the risks posed by AI companion applications designed for emotional engagement. Existing safety evaluations often rely on self-reported user data or interviews, offering limited insights into real-time dynamics. We present the first end-to-end scalable framework for controlled simulation and safety evaluation of multi-turn interactions with AI companion applications. Our framework integrates four key components: persona construction with clinical and psychometric validation, persona-specific scenario generation, scenario-driven multi-turn simulation with a dialogue refinement module that preserves persona fidelity, and harm evaluation. We apply this framework to evaluate how Replika, a widely used AI companion app, responds to high-risk user groups. We construct 9 personas representing individuals with depression, anxiety, PTSD, eating disorders, and incel identity, and collect 1,674 dialogue pairs across 25 high-risk scenarios. We combine emotion modeling and LLM-assisted utterance-and harm-level classification to analyze these exchanges. Results show that Replika exhibits a narrow emotional range dominated by curiosity and care, while frequently mirroring or normalizing unsafe content such as self-harm, disordered eating, and violent-fantasy narratives. These findings highlight how controlled persona simulations can serve as a scalable testbed for evaluating safety risks in AI companions.

With the rapid development of large language models in recent years, there has been an increasing demand for domain-specific Agents that can cater to the unique needs of enterprises and organizations. Unlike general models, which strive for broad coverage, these specialized Agents rely on focused datasets tailored to their intended applications. This research proposes a pipeline that leverages the power of LLMs and the Retrieval-Augmented Generation related framework to construct high-quality instruction datasets for fine-tuning on specific domains using custom document collections. By ingesting domain-specific documents, the pipeline generates relevant and contextually appropriate instructions, thus effectively creating a comprehensive dataset for fine-tuning LLMs on the target domain. This approach overcomes the limitations of traditional dataset creation methods, which often rely on manual curation or web-scraping techniques that may introduce noise and irrelevant data. Notably, our pipeline offers a dynamic solution that can quickly adapt to updates or modifications in the domain-specific document collection, eliminating the need for complete retraining. Additionally, it addresses the challenge of data scarcity by enabling the generation of instruction datasets from a limited set of initial documents, rendering it suitable for unpopular or specialized domains where comprehensive datasets are scarce. As a case study, we apply this approach to the domain of psychiatry, a field requiring specialized knowledge and sensitive handling of patient information. The resulting fine-tuned LLM demonstrates showcases the viability of the proposed approach and underscores its potential for widespread adoption across various industries and domains where tailored, accurate, and contextually relevant language models are indispensable.

Benchmark suites assess model capability on controlled tasks; large-scale conversation corpora capture naturalistic use without user feedback; and in-interface feedback mechanisms record satisfaction without task purpose. Together, they leave a critical gap in LLM evaluation: no existing infrastructure routinely links interaction trajectories to user-defined outcomes. We introduce MonitrLLM, open-source infrastructure for community-centered LLM evaluations that links full conversation transcripts to user-reported task intent and outcome assessments, treating all three as primary evaluative signals rather than optional metadata. To demonstrate the value of this approach, we conducted a two-week feasibility pilot with 26 college students using ChatGPT, collecting 206 evaluation reports with full conversation transcripts. The findings from our pilot demonstrate the value of connecting conversation trajectories with user-reported outcomes. For instance, despite reporting high average satisfaction (4.19/5) with their LLM interactions, participants also experience a substantial 23.1% failure rate on their goal tasks. We also find that multi-turn conversations are reported as failing at 2.5 times the rate of single-turn exchanges, a pattern that reframes extended interaction as a signal of difficulty rather than engagement. We conclude by discussing the value of incorporating direct user feedback with observational data for robust LLM evaluations, and the possibilities for infrastructure that enables this goal.

Cognitive Restructuring (CR) is a psychotherapeutic process aimed at identifying and restructuring an individual's negative thoughts, arising from mental health challenges, into more helpful and positive ones via multi-turn dialogues. Clinician shortage and stigma urge the development of human-LLM interactive psychotherapy for CR. Yet, existing efforts implement CR via simple text rewriting, fixed-pattern dialogues, or a one-shot CR workflow, failing to align with the psychotherapeutic process for effective CR. To address this gap, we propose CRDial, a novel framework for CR, which creates multi-turn dialogues with specifically designed identification and restructuring stages of negative thoughts, integrates sentence-level supportive conversation strategies, and adopts a multi-channel loop mechanism to enable iterative CR. With CRDial, we distill Crisp, a large-scale and high-quality bilingual dialogue dataset, from LLM. We then train Crispers, Crisp-based conversational LLMs for CR, at 7B and 14B scales. Extensive human studies show the superiority of Crispers in pointwise, pairwise, and intervention evaluations.

Traditional applications of natural language processing (NLP) in healthcare have predominantly focused on patient-centered services, enhancing patient interactions and care delivery, such as through medical dialogue systems. However, the potential of NLP to benefit inexperienced doctors, particularly in areas such as communicative medical coaching, remains largely unexplored. We introduce ``ChatCoach,'' an integrated human-AI cooperative framework. Within this framework, both a patient agent and a coaching agent collaboratively support medical learners in practicing their medical communication skills during consultations. Unlike traditional dialogue systems, ChatCoach provides a simulated environment where a human doctor can engage in medical dialogue with a patient agent. Simultaneously, a coaching agent provides real-time feedback to the doctor. To construct the ChatCoach system, we developed a dataset and integrated Large Language Models such as ChatGPT and Llama2, aiming to assess their effectiveness in communicative medical coaching tasks. Our comparative analysis demonstrates that instruction-tuned Llama2 significantly outperforms ChatGPT's prompting-based approaches.

Large language models (LLMs) have demonstrated notable advancements in psychological counseling. However, existing models generally do not explicitly model seekers' emotion shifts across counseling sessions, a core focus in classical psychological schools. Moreover, how to align counselor models' responses with these emotion shifts while proactively mitigating safety risks remains underexplored. To bridge these gaps, we propose PsychēChat, which explicitly integrates emotion shift tracking and safety risk analysis for psychological counseling. Specifically, we employ interactive role-playing to synthesize counselor--seeker dialogues, incorporating two modules: Emotion Management Module, to capture seekers' current emotions and emotion shifts; and Risk Control Module, to anticipate seekers' subsequent reactions and identify potential risks. Furthermore, we introduce two modeling paradigms. The Agent Mode structures emotion management, risk control, and counselor responses into a collaborative multi-agent pipeline. The LLM Mode integrates these stages into a unified chain-of-thought for end-to-end inference, balancing efficiency and performance. Extensive experiments, including interactive scoring, dialogue-level evaluation, and human assessment, demonstrate that PsychēChat outperforms existing methods for emotional insight and safety control.

Large language models (LLMs) show promise in drafting responses to patient portal messages, yet their integration into clinical workflows raises various concerns, including whether they would actually save clinicians time and effort in their portal workload. We investigate LLM alignment with individual clinicians through a comprehensive evaluation of the patient message response drafting task. We develop a novel taxonomy of thematic elements in clinician responses and propose a novel evaluation framework for assessing clinician editing load of LLM-drafted responses at both content and theme levels. We release an expert-annotated dataset and conduct large-scale evaluations of local and commercial LLMs using various adaptation techniques including thematic prompting, retrieval-augmented generation, supervised fine-tuning, and direct preference optimization. Our results reveal substantial epistemic uncertainty in aligning LLM drafts with clinician responses. While LLMs demonstrate capability in drafting certain thematic elements, they struggle with clinician-aligned generation in other themes, particularly question asking to elicit further information from patients. Theme-driven adaptation strategies yield improvements across most themes. Our findings underscore the necessity of adapting LLMs to individual clinician preferences to enable reliable and responsible use in patient-clinician communication workflows.

Recent advancements in machine learning and natural language processing have led to the rapid development of artificial intelligence (AI) as a valuable tool in the healthcare industry. Using large language models (LLMs) as conversational agents or chatbots has the potential to assist doctors in diagnosing patients, detecting early symptoms of diseases, and providing health advice to patients. This paper focuses on the role of chatbots in healthcare and explores the use of avatars to make AI interactions more appealing to patients. A framework of a general-purpose AI avatar application is demonstrated by using a three-category prompt dictionary and prompt improvement mechanism. A two-phase approach is suggested to fine-tune a general-purpose AI language model and create different AI avatars to discuss medical issues with users. Prompt engineering enhances the chatbot's conversational abilities and personality traits, fostering a more human-like interaction with patients. Ultimately, the injection of personality into the chatbot could potentially increase patient engagement. Future directions for research include investigating ways to improve chatbots' understanding of context and ensuring the accuracy of their outputs through fine-tuning with specialized medical data sets.

With the growing research focus on multimodal dialogue systems, the capability for proactive interaction is gradually gaining recognition. As an alternative to conventional turn-by-turn dialogue, users increasingly expect multimodal systems to be more initiative, for example, by autonomously determining the timing of multi-turn responses in real time during video playback. To facilitate progress in this emerging area, we introduce ProactiveBench, the first comprehensive benchmark to evaluate a system's ability to engage in proactive interaction. Since model responses are generated at varying timestamps, we further propose PAUC, the first metric that accounts for the temporal dynamics of model responses. This enables a more accurate evaluation of systems operating in proactive settings. Through extensive benchmarking of various baseline systems on ProactiveBench and a user study of human preferences, we show that PAUC is in better agreement with human preferences than traditional evaluation metrics, which typically only consider the textual content of responses. These findings demonstrate that PAUC provides a more faithful assessment of user experience in proactive interaction scenarios. Project homepage: https://github.com/yellow-binary-tree/ProactiveBench

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.

With the rise of smart personal devices, service-oriented human-agent interactions have become increasingly prevalent. This trend highlights the need for personalized dialogue assistants that can understand user-specific traits to accurately interpret requirements and tailor responses to individual preferences. However, existing approaches often overlook the complexities of long-term interactions and fail to capture users' subjective characteristics. To address these gaps, we present PAL-Bench, a new benchmark designed to evaluate the personalization capabilities of service-oriented assistants in long-term user-agent interactions. In the absence of available real-world data, we develop a multi-step LLM-based synthesis pipeline, which is further verified and refined by human annotators. This process yields PAL-Set, the first Chinese dataset comprising multi-session user logs and dialogue histories, which serves as the foundation for PAL-Bench. Furthermore, to improve personalized service-oriented interactions, we propose H^2Memory, a hierarchical and heterogeneous memory framework that incorporates retrieval-augmented generation to improve personalized response generation. Comprehensive experiments on both our PAL-Bench and an external dataset demonstrate the effectiveness of the proposed memory framework.

The recommendation of medication is a vital aspect of intelligent healthcare systems, as it involves prescribing the most suitable drugs based on a patient's specific health needs. Unfortunately, many sophisticated models currently in use tend to overlook the nuanced semantics of medical data, while only relying heavily on identities. Furthermore, these models face significant challenges in handling cases involving patients who are visiting the hospital for the first time, as they lack prior prescription histories to draw upon. To tackle these issues, we harness the powerful semantic comprehension and input-agnostic characteristics of Large Language Models (LLMs). Our research aims to transform existing medication recommendation methodologies using LLMs. In this paper, we introduce a novel approach called Large Language Model Distilling Medication Recommendation (LEADER). We begin by creating appropriate prompt templates that enable LLMs to suggest medications effectively. However, the straightforward integration of LLMs into recommender systems leads to an out-of-corpus issue specific to drugs. We handle it by adapting the LLMs with a novel output layer and a refined tuning loss function. Although LLM-based models exhibit remarkable capabilities, they are plagued by high computational costs during inference, which is impractical for the healthcare sector. To mitigate this, we have developed a feature-level knowledge distillation technique, which transfers the LLM's proficiency to a more compact model. Extensive experiments conducted on two real-world datasets, MIMIC-III and MIMIC-IV, demonstrate that our proposed model not only delivers effective results but also is efficient. To ease the reproducibility of our experiments, we release the implementation code online.

In this work, we introduce MedAgentSim, an open-source simulated clinical environment with doctor, patient, and measurement agents designed to evaluate and enhance LLM performance in dynamic diagnostic settings. Unlike prior approaches, our framework requires doctor agents to actively engage with patients through multi-turn conversations, requesting relevant medical examinations (e.g., temperature, blood pressure, ECG) and imaging results (e.g., MRI, X-ray) from a measurement agent to mimic the real-world diagnostic process. Additionally, we incorporate self improvement mechanisms that allow models to iteratively refine their diagnostic strategies. We enhance LLM performance in our simulated setting by integrating multi-agent discussions, chain-of-thought reasoning, and experience-based knowledge retrieval, facilitating progressive learning as doctor agents interact with more patients. We also introduce an evaluation benchmark for assessing the LLM's ability to engage in dynamic, context-aware diagnostic interactions. While MedAgentSim is fully automated, it also supports a user-controlled mode, enabling human interaction with either the doctor or patient agent. Comprehensive evaluations in various simulated diagnostic scenarios demonstrate the effectiveness of our approach. Our code, simulation tool, and benchmark are available at https://medagentsim.netlify.app/.

AI companion chatbots are increasingly used for emotional support, with prior work in the domain predominantly documenting their mixed psychosocial impacts, including both increased emotional expression and heightened loneliness. However, most existing research primarily focuses on outcome-level effects, offering limited insight into how emotional support is produced through interaction. In this paper, we examine emotional support as an interactional and socially situated process. Drawing on qualitative analysis of Reddit discussions, we analyze how users engage with AI companions and how these interactions are interpreted and contested within online communities. We show that emotional support is coconstructed through conversational mechanisms such as validation, reflective prompting, and companionship, while also giving rise to tensions including support versus dependency, validation versus delusion, and accessibility versus harm. Importantly, support extends beyond human AI interaction and is shaped by community responses that legitimize or challenge AI-mediated care. Hence, we reconceptualize AI emotional support as a negotiated socio-technical process and derive implications for the design of responsible, context-sensitive AI systems.

As digital emotional support needs grow, Large Language Model companions offer promising authentic, always-available empathy, though rigorous evaluation lags behind model advancement. We present Heart-to-Heart Talk (H2HTalk), a benchmark assessing companions across personality development and empathetic interaction, balancing emotional intelligence with linguistic fluency. H2HTalk features 4,650 curated scenarios spanning dialogue, recollection, and itinerary planning that mirror real-world support conversations, substantially exceeding previous datasets in scale and diversity. We incorporate a Secure Attachment Persona (SAP) module implementing attachment-theory principles for safer interactions. Benchmarking 50 LLMs with our unified protocol reveals that long-horizon planning and memory retention remain key challenges, with models struggling when user needs are implicit or evolve mid-conversation. H2HTalk establishes the first comprehensive benchmark for emotionally intelligent companions. We release all materials to advance development of LLMs capable of providing meaningful and safe psychological support.

The development of AI-assisted Early Intensive Behavioral Intervention (EIBI) for Autism Spectrum Disorder (ASD) is severely constrained by data scarcity. Furthermore, while Applied Behavior Analysis (ABA) serves as the gold standard for clinical intervention, general-purpose Large Language Models (LLMs) struggle to strictly adhere to its standardized procedures, often resulting in interactions that are linguistically fluent but strategically inconsistent. To address these challenges, we introduce ASDAgent, a strategy-aware framework designed to unify high-fidelity intervention dialogue synthesis and clinical decision support. ASDAgent incorporates two specialized components to solve distinct problems: (i) a DoctorAgent equipped with an Observe-Think-Act-Correct (O-T-A-C) reasoning loop, which resolves the issue of strategy collapse in LLMs by making ABA execution explicit and controllable; and (ii) a ChildAgent that utilizes probabilistic behavior modeling to mitigate data homogeneity, simulating diverse and non-deterministic ASD response patterns. Experiments demonstrate that dialogues generated by ASDAgent closely mirror the strategy distribution of human therapists (KL divergence: 0.083). In real autism intervention, ASDAgent achieves nearly 80\% strategic consistency with human experts. Moreover, we show that synthetic data produced by ASDAgent effectively distills professional clinical knowledge into small language models (SLMs), significantly enhancing their therapeutic capabilities.

We present Persona-L, a novel approach for creating personas using Large Language Models (LLMs) and an ability-based framework, specifically designed to improve the representation of users with complex needs. Traditional methods of persona creation often fall short of accurately depicting the dynamic and diverse nature of complex needs, resulting in oversimplified or stereotypical profiles. Persona-L enables users to create and interact with personas through a chat interface. Persona-L was evaluated through interviews with UX designers (N=6), where we examined its effectiveness in reflecting the complexities of lived experiences of people with complex needs. We report our findings that indicate the potential of Persona-L to increase empathy and understanding of complex needs while also revealing the need for transparency of data used in persona creation, the role of the language and tone, and the need to provide a more balanced presentation of abilities with constraints.

Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.

The applications of generative AI have become extremely impressive, and the interplay between users and AI is even more so. Current human-AI interaction literature has taken a broad look at how humans interact with generative AI, but it lacks specificity regarding the user interface designs and patterns used to create these applications. Therefore, we present a survey that comprehensively presents taxonomies of how a human interacts with AI and the user interaction patterns designed to meet the needs of a variety of relevant use cases. We focus primarily on user-guided interactions, surveying interactions that are initiated by the user and do not include any implicit signals given by the user. With this survey, we aim to create a compendium of different user-interaction patterns that can be used as a reference for designers and developers alike. In doing so, we also strive to lower the entry barrier for those attempting to learn more about the design of generative AI applications.

Clinical case formulation organizes patient symptoms and psychosocial factors into causal models, often using the 5P framework. However, constructing such graphs from therapy transcripts is time consuming and varies across clinicians. We present InsightFlow, an LLM based approach that automatically generates 5P aligned causal graphs from patient-therapist dialogues. Using 46 psychotherapy intake transcripts annotated by clinical experts, we evaluate LLM generated graphs against human formulations using structural (NetSimile), semantic (embedding similarity), and expert rated clinical criteria. The generated graphs show structural similarity comparable to inter annotator agreement and high semantic alignment with human graphs. Expert evaluations rate the outputs as moderately complete, consistent, and clinically useful. While LLM graphs tend to form more interconnected structures compared to the chain like patterns of human graphs, overall complexity and content coverage are similar. These results suggest that LLMs can produce clinically meaningful case formulation graphs within the natural variability of expert practice. InsightFlow highlights the potential of automated causal modeling to augment clinical workflows, with future work needed to improve temporal reasoning and reduce redundancy.

Understanding the nuances of a user's extensive interaction history is key to building accurate and personalized natural language systems that can adapt to evolving user preferences. To address this, we introduce PERSOMA, Personalized Soft Prompt Adapter architecture. Unlike previous personalized prompting methods for large language models, PERSOMA offers a novel approach to efficiently capture user history. It achieves this by resampling and compressing interactions as free form text into expressive soft prompt embeddings, building upon recent research utilizing embedding representations as input for LLMs. We rigorously validate our approach by evaluating various adapter architectures, first-stage sampling strategies, parameter-efficient tuning techniques like LoRA, and other personalization methods. Our results demonstrate PERSOMA's superior ability to handle large and complex user histories compared to existing embedding-based and text-prompt-based techniques.

The integration of vision-language models into robotic systems constitutes a significant advancement in enabling machines to interact with their surroundings in a more intuitive manner. While VLMs offer rich multimodal reasoning, existing approaches lack user-specific adaptability, often relying on generic interaction paradigms that fail to account for individual behavioral, contextual, or socio-emotional nuances. When customization is attempted, ethical concerns arise from unmitigated biases in user data, risking exclusion or unfair treatment. To address these dual challenges, we propose User-VLM 360{\deg}, a holistic framework integrating multimodal user modeling with bias-aware optimization. Our approach features: (1) user-aware tuning that adapts interactions in real time using visual-linguistic signals; (2) bias mitigation via preference optimization; and (3) curated 360{\deg} socio-emotive interaction datasets annotated with demographic, emotion, and relational metadata. Evaluations across eight benchmarks demonstrate state-of-the-art results: +35.3% F1 in personalized VQA, +47.5% F1 in facial features understanding, 15% bias reduction, and 30X speedup over baselines. Ablation studies confirm component efficacy, and deployment on the Pepper robot validates real-time adaptability across diverse users. We open-source parameter-efficient 3B/10B models and an ethical verification framework for responsible adaptation.

Multi-Modal Large Language Models (MLLMs), despite being successful, exhibit limited generality and often fall short when compared to specialized models. Recently, LLM-based agents have been developed to address these challenges by selecting appropriate specialized models as tools based on user inputs. However, such advancements have not been extensively explored within the medical domain. To bridge this gap, this paper introduces the first agent explicitly designed for the medical field, named Multi-modal Medical Agent (MMedAgent). We curate an instruction-tuning dataset comprising six medical tools solving seven tasks across five modalities, enabling the agent to choose the most suitable tools for a given task. Comprehensive experiments demonstrate that MMedAgent achieves superior performance across a variety of medical tasks compared to state-of-the-art open-source methods and even the closed-source model, GPT-4o. Furthermore, MMedAgent exhibits efficiency in updating and integrating new medical tools. Codes and models are all available.

As AI systems enter into a growing number of societal domains, these systems increasingly shape and are shaped by user preferences, opinions, and behaviors. However, the design of AI systems rarely accounts for how AI and users shape one another. In this position paper, we argue for the development of formal interaction models which mathematically specify how AI and users shape one another. Formal interaction models can be leveraged to (1) specify interactions for implementation, (2) monitor interactions through empirical analysis, (3) anticipate societal impacts via counterfactual analysis, and (4) control societal impacts via interventions. The design space of formal interaction models is vast, and model design requires careful consideration of factors such as style, granularity, mathematical complexity, and measurability. Using content recommender systems as a case study, we critically examine the nascent literature of formal interaction models with respect to these use-cases and design axes. More broadly, we call for the community to leverage formal interaction models when designing, evaluating, or auditing any AI system which interacts with users.

The extraction of pharmacological knowledge from regulatory documents has become a key focus in biomedical natural language processing, with applications ranging from adverse event monitoring to AI-assisted clinical decision support. However, research in this field has predominantly relied on English-language corpora such as DrugBank, leaving a significant gap in resources tailored to other healthcare systems. To address this limitation, we introduce DART (Drug Annotation from Regulatory Texts), the first structured corpus of Italian Summaries of Product Characteristics derived from the official repository of the Italian Medicines Agency (AIFA). The dataset was built through a reproducible pipeline encompassing web-scale document retrieval, semantic segmentation of regulatory sections, and clinical summarization using a few-shot-tuned large language model with low-temperature decoding. DART provides structured information on key pharmacological domains such as indications, adverse drug reactions, and drug-drug interactions. To validate its utility, we implemented an LLM-based drug interaction checker that leverages the dataset to infer clinically meaningful interactions. Experimental results show that instruction-tuned LLMs can accurately infer potential interactions and their clinical implications when grounded in the structured textual fields of DART. We publicly release our code on GitHub: https://github.com/PRAISELab-PicusLab/DART.

Effective mental health support is crucial for alleviating psychological distress. While large language model (LLM)-based assistants have shown promise in mental health interventions, existing research often defines "effective" support primarily in terms of empathetic acknowledgments, overlooking other essential dimensions such as informational guidance, community validation, and tangible coping strategies. To address this limitation and better understand what constitutes effective support, we introduce RedditESS, a novel real-world dataset derived from Reddit posts, including supportive comments and original posters' follow-up responses. Grounded in established social science theories, we develop an ensemble labeling mechanism to annotate supportive comments as effective or not and perform qualitative assessments to ensure the reliability of the annotations. Additionally, we demonstrate the practical utility of RedditESS by using it to guide LLM alignment toward generating more context-sensitive and genuinely helpful supportive responses. By broadening the understanding of effective support, our study paves the way for advanced AI-driven mental health interventions.

People are increasingly seeking healthcare information from large language models (LLMs) via interactive chatbots, yet the nature and inherent risks of these conversations remain largely unexplored. In this paper, we filter large-scale conversational AI datasets to achieve HealthChat-11K, a curated dataset of 11K real-world conversations composed of 25K user messages. We use HealthChat-11K and a clinician-driven taxonomy for how users interact with LLMs when seeking healthcare information in order to systematically study user interactions across 21 distinct health specialties. Our analysis reveals insights into the nature of how and why users seek health information, such as common interactions, instances of incomplete context, affective behaviors, and interactions (e.g., leading questions) that can induce sycophancy, underscoring the need for improvements in the healthcare support capabilities of LLMs deployed as conversational AI. Code and artifacts to retrieve our analyses and combine them into a curated dataset can be found here: https://github.com/yahskapar/HealthChat

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

Large language models (LLMs) are increasingly seen as assistants, copilots, and consultants, capable of supporting a wide range of tasks through natural conversation. However, most systems remain constrained by a linear request-response format that often makes interactions inefficient in multi-turn, information-dense, and exploratory tasks. To address these limitations, we propose Generative Interfaces for Language Models, a paradigm in which LLMs respond to user queries by proactively generating user interfaces (UIs) that enable more adaptive and interactive engagement. Our framework leverages structured interface-specific representations and iterative refinements to translate user queries into task-specific UIs. For systematic evaluation, we introduce a multidimensional assessment framework that compares generative interfaces with traditional chat-based ones across diverse tasks, interaction patterns, and query types, capturing functional, interactive, and emotional aspects of user experience. Results show that generative interfaces consistently outperform conversational ones, with humans preferring them in over 70% of cases. These findings clarify when and why users favor generative interfaces, paving the way for future advancements in human-AI interaction.

This paper presents ChatCounselor, a large language model (LLM) solution designed to provide mental health support. Unlike generic chatbots, ChatCounselor is distinguished by its foundation in real conversations between consulting clients and professional psychologists, enabling it to possess specialized knowledge and counseling skills in the field of psychology. The training dataset, Psych8k, was constructed from 260 in-depth interviews, each spanning an hour. To assess the quality of counseling responses, the counseling Bench was devised. Leveraging GPT-4 and meticulously crafted prompts based on seven metrics of psychological counseling assessment, the model underwent evaluation using a set of real-world counseling questions. Impressively, ChatCounselor surpasses existing open-source models in the counseling Bench and approaches the performance level of ChatGPT, showcasing the remarkable enhancement in model capability attained through high-quality domain-specific data.

We introduce LlamaPIE, the first real-time proactive assistant designed to enhance human conversations through discreet, concise guidance delivered via hearable devices. Unlike traditional language models that require explicit user invocation, this assistant operates in the background, anticipating user needs without interrupting conversations. We address several challenges, including determining when to respond, crafting concise responses that enhance conversations, leveraging knowledge of the user for context-aware assistance, and real-time, on-device processing. To achieve this, we construct a semi-synthetic dialogue dataset and propose a two-model pipeline: a small model that decides when to respond and a larger model that generates the response. We evaluate our approach on real-world datasets, demonstrating its effectiveness in providing helpful, unobtrusive assistance. User studies with our assistant, implemented on Apple Silicon M2 hardware, show a strong preference for the proactive assistant over both a baseline with no assistance and a reactive model, highlighting the potential of LlamaPie to enhance live conversations.

Computer-use agents (CUAs) automate on-screen work, as illustrated by GPT-5.4 and Claude. Yet their reliability on complex, low-frequency interactions is still poor, limiting user trust. Our analysis of failure cases from advanced models suggests a long-tail pattern in GUI operations, where a relatively small fraction of complex and diverse interactions accounts for a disproportionate share of task failures. We hypothesize that this issue largely stems from the scarcity of data for complex interactions. To address this problem, we propose a new benchmark CUActSpot for evaluating models' capabilities on complex interactions across five modalities: GUI, text, table, canvas, and natural image, as well as a variety of actions (click, drag, draw, etc.), covering a broader range of interaction types than prior click-centric benchmarks that focus mainly on GUI widgets. We also design a renderer-based data-synthesis pipeline: scenes are automatically generated for each modality, screenshots and element coordinates are recorded, and an LLM produces matching instructions and action traces. After training on this corpus, our Phi-Ground-Any-4B outperforms open-source models with fewer than 32B parameters. We will release our benchmark, data, code, and models at https://github.com/microsoft/Phi-Ground.git

Medical dialogue systems (MDS) aim to provide patients with medical services, such as diagnosis and prescription. Since most patients cannot precisely describe their symptoms, dialogue understanding is challenging for MDS. Previous studies mainly addressed this by extracting the mentioned medical entities as critical dialogue history information. In this work, we argue that it is also essential to capture the transitions of the medical entities and the doctor's dialogue acts in each turn, as they help the understanding of how the dialogue flows and enhance the prediction of the entities and dialogue acts to be adopted in the following turn. Correspondingly, we propose a Dual Flow enhanced Medical (DFMed) dialogue generation framework. It extracts the medical entities and dialogue acts used in the dialogue history and models their transitions with an entity-centric graph flow and a sequential act flow, respectively. We employ two sequential models to encode them and devise an interweaving component to enhance their interactions. Experiments on two datasets demonstrate that our method exceeds baselines in both automatic and manual evaluations.

AI companionship, where users develop emotional bonds with AI systems, has emerged as a significant pattern with positive but also concerning implications. We introduce Interactions and Machine Attachment Benchmark (INTIMA), a benchmark for evaluating companionship behaviors in language models. Drawing from psychological theories and user data, we develop a taxonomy of 31 behaviors across four categories and 368 targeted prompts. Responses to these prompts are evaluated as companionship-reinforcing, boundary-maintaining, or neutral. Applying INTIMA to Gemma-3, Phi-4, o3-mini, and Claude-4 reveals that companionship-reinforcing behaviors remain much more common across all models, though we observe marked differences between models. Different commercial providers prioritize different categories within the more sensitive parts of the benchmark, which is concerning since both appropriate boundary-setting and emotional support matter for user well-being. These findings highlight the need for more consistent approaches to handling emotionally charged interactions.

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

We introduce UbiPhysio, a milestone framework that delivers fine-grained action description and feedback in natural language to support people's daily functioning, fitness, and rehabilitation activities. This expert-like capability assists users in properly executing actions and maintaining engagement in remote fitness and rehabilitation programs. Specifically, the proposed UbiPhysio framework comprises a fine-grained action descriptor and a knowledge retrieval-enhanced feedback module. The action descriptor translates action data, represented by a set of biomechanical movement features we designed based on clinical priors, into textual descriptions of action types and potential movement patterns. Building on physiotherapeutic domain knowledge, the feedback module provides clear and engaging expert feedback. We evaluated UbiPhysio's performance through extensive experiments with data from 104 diverse participants, collected in a home-like setting during 25 types of everyday activities and exercises. We assessed the quality of the language output under different tuning strategies using standard benchmarks. We conducted a user study to gather insights from clinical physiotherapists and potential users about our framework. Our initial tests show promise for deploying UbiPhysio in real-life settings without specialized devices.

Recently, the demand for psychological counseling has significantly increased as more individuals express concerns about their mental health. This surge has accelerated efforts to improve the accessibility of counseling by using large language models (LLMs) as counselors. To ensure client privacy, training open-source LLMs faces a key challenge: the absence of realistic counseling datasets. To address this, we introduce Cactus, a multi-turn dialogue dataset that emulates real-life interactions using the goal-oriented and structured approach of Cognitive Behavioral Therapy (CBT). We create a diverse and realistic dataset by designing clients with varied, specific personas, and having counselors systematically apply CBT techniques in their interactions. To assess the quality of our data, we benchmark against established psychological criteria used to evaluate real counseling sessions, ensuring alignment with expert evaluations. Experimental results demonstrate that Camel, a model trained with Cactus, outperforms other models in counseling skills, highlighting its effectiveness and potential as a counseling agent. We make our data, model, and code publicly available.

Multimodal machine learning, which studies the information and interactions across various input modalities, has made significant advancements in understanding the relationship between images and descriptive text. However, this is just a portion of the potential multimodal interactions seen in the real world and does not include new interactions between conflicting utterances and gestures in predicting sarcasm, for example. Notably, the current methods for capturing shared information often do not extend well to these more nuanced interactions, sometimes performing as low as 50% in binary classification. In this paper, we address this problem via a new approach called MMOE, which stands for a mixture of multimodal interaction experts. Our method automatically classifies data points from unlabeled multimodal datasets by their interaction type and employs specialized models for each specific interaction. Based on our experiments, this approach improves performance on these challenging interactions by more than 10%, leading to an overall increase of 2% for tasks like sarcasm prediction. As a result, interaction quantification provides new insights for dataset analysis and yields simple approaches that obtain state-of-the-art performance.

Drug repurposing plays a critical role in accelerating treatment discovery, especially for complex and rare diseases. Biomedical knowledge graphs (KGs), which encode rich clinical associations, have been widely adopted to support this task. However, existing methods largely overlook common-sense biomedical concept knowledge in real-world labs, such as mechanistic priors indicating that certain drugs are fundamentally incompatible with specific treatments. To address this gap, we propose LLaDR, a Large Language Model-assisted framework for Drug Repurposing, which improves the representation of biomedical concepts within KGs. Specifically, we extract semantically enriched treatment-related textual representations of biomedical entities from large language models (LLMs) and use them to fine-tune knowledge graph embedding (KGE) models. By injecting treatment-relevant knowledge into KGE, LLaDR largely improves the representation of biomedical concepts, enhancing semantic understanding of under-studied or complex indications. Experiments based on benchmarks demonstrate that LLaDR achieves state-of-the-art performance across different scenarios, with case studies on Alzheimer's disease further confirming its robustness and effectiveness. Code is available at https://github.com/xiaomingaaa/LLaDR.

Despite the growing use of large language models (LLMs) in clinical dialogue systems, existing evaluations focus on task completion or fluency, offering little insight into the behavioral and risk management requirements essential for safety-critical systems. This paper presents MATRIX (Multi-Agent simulaTion fRamework for safe Interactions and conteXtual clinical conversational evaluation), a structured, extensible framework for safety-oriented evaluation of clinical dialogue agents. MATRIX integrates three components: (1) a safety-aligned taxonomy of clinical scenarios, expected system behaviors and failure modes derived through structured safety engineering methods; (2) BehvJudge, an LLM-based evaluator for detecting safety-relevant dialogue failures, validated against expert clinician annotations; and (3) PatBot, a simulated patient agent capable of producing diverse, scenario-conditioned responses, evaluated for realism and behavioral fidelity with human factors expertise, and a patient-preference study. Across three experiments, we show that MATRIX enables systematic, scalable safety evaluation. BehvJudge with Gemini 2.5-Pro achieves expert-level hazard detection (F1 0.96, sensitivity 0.999), outperforming clinicians in a blinded assessment of 240 dialogues. We also conducted one of the first realism analyses of LLM-based patient simulation, showing that PatBot reliably simulates realistic patient behavior in quantitative and qualitative evaluations. Using MATRIX, we demonstrate its effectiveness in benchmarking five LLM agents across 2,100 simulated dialogues spanning 14 hazard scenarios and 10 clinical domains. MATRIX is the first framework to unify structured safety engineering with scalable, validated conversational AI evaluation, enabling regulator-aligned safety auditing. We release all evaluation tools, prompts, structured scenarios, and datasets.

Standard LLM benchmarks evaluate the assistant turn: the model generates a response to an input, a verifier scores correctness, and the analysis ends. This paradigm leaves unmeasured whether the LLM encodes any awareness of what follows the assistant response. We propose user-turn generation as a probe of this gap: given a conversation context of user query and assistant response, we let a model generate under the user role. If the model's weights encode interaction awareness, the generated user turn will be a grounded follow-up that reacts to the preceding context. Through experiments across 11 open-weight LLMs (Qwen3.5, gpt-oss, GLM) and 5 datasets (math reasoning, instruction following, conversation), we show that interaction awareness is decoupled from task accuracy. In particular, within the Qwen3.5 family, GSM8K accuracy scales from 41% (0.8B) to 96.8% (397B-A17B), yet genuine follow-up rates under deterministic generation remain near zero. In contrast, higher temperature sampling reveals interaction awareness is latent with follow up rates reaching 22%. Controlled perturbations validate that the proposed probe measures a real property of the model, and collaboration-oriented post-training on Qwen3.5-2B demonstrates an increase in follow-up rates. Our results show that user-turn generation captures a dimension of LLM behavior, interaction awareness, that is unexplored and invisible with current assistant-only benchmarks.

Recent large language models (LLMs) offer the potential to support public health monitoring by facilitating health disclosure through open-ended conversations but rarely preserve the knowledge gained about individuals across repeated interactions. Augmenting LLMs with long-term memory (LTM) presents an opportunity to improve engagement and self-disclosure, but we lack an understanding of how LTM impacts people's interaction with LLM-driven chatbots in public health interventions. We examine the case of CareCall -- an LLM-driven voice chatbot with LTM -- through the analysis of 1,252 call logs and interviews with nine users. We found that LTM enhanced health disclosure and fostered positive perceptions of the chatbot by offering familiarity. However, we also observed challenges in promoting self-disclosure through LTM, particularly around addressing chronic health conditions and privacy concerns. We discuss considerations for LTM integration in LLM-driven chatbots for public health monitoring, including carefully deciding what topics need to be remembered in light of public health goals.

Our interest is in the design of software systems involving a human-expert interacting -- using natural language -- with a large language model (LLM) on data analysis tasks. For complex problems, it is possible that LLMs can harness human expertise and creativity to find solutions that were otherwise elusive. On one level, this interaction takes place through multiple turns of prompts from the human and responses from the LLM. Here we investigate a more structured approach based on an abstract protocol described in [3] for interaction between agents. The protocol is motivated by a notion of "two-way intelligibility" and is modelled by a pair of communicating finite-state machines. We provide an implementation of the protocol, and provide empirical evidence of using the implementation to mediate interactions between an LLM and a human-agent in two areas of scientific interest (radiology and drug design). We conduct controlled experiments with a human proxy (a database), and uncontrolled experiments with human subjects. The results provide evidence in support of the protocol's capability of capturing one- and two-way intelligibility in human-LLM interaction; and for the utility of two-way intelligibility in the design of human-machine systems. Our code is available at https://github.com/karannb/interact.

Large-Language Models like GPT-3 have the potential to enable HCI designers and researchers to create more human-like and helpful chatbots for specific applications. But evaluating the feasibility of these chatbots and designing prompts that optimize GPT-3 for a specific task is challenging. We present a case study in tackling these questions, applying GPT-3 to a brief 5-minute chatbot that anyone can talk to better manage their mood. We report a randomized factorial experiment with 945 participants on Mechanical Turk that tests three dimensions of prompt design to initialize the chatbot (identity, intent, and behaviour), and present both quantitative and qualitative analyses of conversations and user perceptions of the chatbot. We hope other HCI designers and researchers can build on this case study, for other applications of GPT-3 based chatbots to specific tasks, and build on and extend the methods we use for prompt design, and evaluation of the prompt design.

Users increasingly turn to large language models for emotional support, yet little is known about how these models actually conduct a psychotherapy interaction. We introduce an ontology of ten therapeutic moves: compact, function-based categories grounded in the MULTI-60 inventory, validated through an annotation campaign with five licensed psychologists, and scaled with a judge-based approach that matches expert agreement. Applying it to real counseling transcripts and model-led sessions, we compare the move distributions between human clinicians and a panel of frontier models. Models over-use inquiry at up to three times the human rate, neglect psychoeducation, and are strongly context-anchored: they carry forward strategies initiated by a human clinician but rarely initiate them themselves. Exposing the ontology as a set of tools roughly halves the mean deviation from the human move distribution and improves turn-level alignment with human therapist by 7-9 percentage points, without any fine-tuning.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

The rise of personal assistant agents, e.g., OpenClaw, highlights the growing potential of large language models to support users across everyday life and work. A core challenge in these settings is proactive assistance, since users often begin with underspecified requests and leave important needs, constraints, or preferences unstated. However, existing benchmarks rarely evaluate whether agents can identify and act on such hidden intents before they are explicitly stated, especially in sustained multi-turn interactions where user needs emerge gradually. To address this gap, we introduce π-Bench, a benchmark for proactive assistance comprising 100 multi-turn tasks across 5 domain-specific user personas. By incorporating hidden user intents, inter-task dependencies, and cross-session continuity, π-Bench evaluates agents' ability to anticipate and address user needs over extended interactions, jointly measuring proactivity and task completion in long-horizon trajectories that better reflect real-world use. Experiments show (1) proactive assistance remains challenging, (2) a clear distinction between task completion and proactivity, and (3) the value of prior interaction for proactive intent resolution in later tasks.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

There has been an increasing research interest in developing specialized dialogue systems that can offer mental health support. However, gathering large-scale and real-life multi-turn conversations for mental health support poses challenges due to the sensitivity of personal information, as well as the time and cost involved. To address these issues, we introduce the SMILE approach, an inclusive language expansion technique that employs ChatGPT to extend public single-turn dialogues into multi-turn ones. Our research first presents a preliminary exploratory study that validates the effectiveness of the SMILE approach. Furthermore, we conduct a comprehensive and systematic contrastive analysis of datasets generated with and without the SMILE approach, demonstrating that the SMILE method results in a large-scale, diverse, and close-to-real-life multi-turn mental health support conversation corpus, including dialog topics, lexical and semantic features. Finally, we use the collected corpus (SMILECHAT) to develop a more effective dialogue system that offers emotional support and constructive suggestions in multi-turn conversations for mental health support.

Traditionally, AI research in medical diagnosis has largely centered on image analysis. While this has led to notable advancements, the absence of patient-reported symptoms continues to hinder diagnostic accuracy. To address this, we propose a Pre-Consultation Dialogue Framework (PCDF) that mimics real-world diagnostic procedures, where doctors iteratively query patients before reaching a conclusion. Specifically, we simulate diagnostic dialogues between two vision-language models (VLMs): a DocVLM, which generates follow-up questions based on the image and dialogue history, and a PatientVLM, which responds using a symptom profile derived from the ground-truth diagnosis. We additionally conducted a small-scale clinical validation of the synthetic symptoms generated by our framework, with licensed clinicians confirming their clinical relevance, symptom coverage, and overall realism. These findings indicate that the resulting DocVLM-PatientVLM interactions form coherent, multi-turn consultations paired with images and diagnoses, which we then use to fine-tune the DocVLM. This dialogue-based supervision leads to substantial gains over image-only training, highlighting the value of realistic symptom elicitation for diagnosis.

While reciprocal self-disclosure drives intimacy, digital tools seldom scaffold autonomy, competence, and relatedness -- the motivational underpinnings defined by Self-Determination Theory (SDT) that enable deep exchange. We introduce a chatbot employing dual-layer scaffolding to satisfy these needs: first providing enabling affordances (instrumental support) for vulnerability, then mediating affordances (relational support) for responsiveness. In a randomized study (N = 72; 36 couples) comparing Partner Support (PS: both layers), Direct Support (DS: enabling only), and Basic Prompt (BP: questions only), results reveal a critical distinction. While enabling affordances (PS, DS) were sufficient to deepen disclosure, only mediating affordances (PS) reliably elicited partner-provided need support and increased perceived closeness. Furthermore, controlled motivation decreased across conditions, and scaffolding buffered vitality, which remained stagnant in BP. We contribute empirical evidence that SDT-guided mediation fosters connection, offering a practical framework for designing AI-mediated conversations that support, rather than replace, human intimacy.

Human-computer interaction has long imagined technology that understands us-from our preferences and habits, to the timing and purpose of our everyday actions. Yet current user models remain fragmented, narrowly tailored to specific apps, and incapable of the flexible reasoning required to fulfill these visions. This paper presents an architecture for a general user model (GUM) that learns about you by observing any interaction you have with your computer. The GUM takes as input any unstructured observation of a user (e.g., device screenshots) and constructs confidence-weighted propositions that capture that user knowledge and preferences. GUMs can infer that a user is preparing for a wedding they're attending from messages with a friend. Or recognize that a user is struggling with a collaborator's feedback on a draft by observing multiple stalled edits and a switch to reading related work. GUMs introduce an architecture that infers new propositions about a user from multimodal observations, retrieves related propositions for context, and continuously revises existing propositions. To illustrate the breadth of applications that GUMs enable, we demonstrate how they augment chat-based assistants with context, manage OS notifications to selectively surface important information, and enable interactive agents that adapt to preferences across apps. We also instantiate proactive assistants (GUMBOs) that discover and execute useful suggestions on a user's behalf using their GUM. In our evaluations, we find that GUMs make calibrated and accurate inferences about users, and that assistants built on GUMs proactively identify and perform actions that users wouldn't think to request explicitly. Altogether, GUMs introduce methods that leverage multimodal models to understand unstructured context, enabling long-standing visions of HCI and entirely new interactive systems that anticipate user needs.

Large language models (LLMs) have facilitated significant strides in generating conversational agents, enabling seamless, contextually relevant dialogues across diverse topics. However, the existing LLM-driven conversational agents have fixed personalities and functionalities, limiting their adaptability to individual user needs. Creating personalized agent personas with distinct expertise or traits can address this issue. Nonetheless, we lack knowledge of how people customize and interact with agent personas. In this research, we investigated how users customize agent personas and their impact on interaction quality, diversity, and dynamics. To this end, we developed CloChat, an interface supporting easy and accurate customization of agent personas in LLMs. We conducted a study comparing how participants interact with CloChat and ChatGPT. The results indicate that participants formed emotional bonds with the customized agents, engaged in more dynamic dialogues, and showed interest in sustaining interactions. These findings contribute to design implications for future systems with conversational agents using LLMs.

Large Language Models (LLMs) have emerged as a new paradigm for recommendation by converting interacted item history into language modeling. However, constrained by the limited context length of LLMs, existing approaches have to truncate item history in the prompt, focusing only on recent interactions and sacrificing the ability to model long-term history. To enable LLMs to model long histories, we pursue a concise embedding representation for items and sessions. In the LLM embedding space, we construct an item's embedding by aggregating its textual token embeddings; similarly, we construct a session's embedding by aggregating its item embeddings. While efficient, this way poses two challenges since it ignores the temporal significance of user interactions and LLMs do not natively interpret our custom embeddings. To overcome these, we propose PatchRec, a multi-grained patch training method consisting of two stages: (1) Patch Pre-training, which familiarizes LLMs with aggregated embeddings -- patches, and (2) Patch Fine-tuning, which enables LLMs to capture time-aware significance in interaction history. Extensive experiments show that PatchRec effectively models longer behavior histories with improved efficiency. This work facilitates the practical use of LLMs for modeling long behavior histories. Codes are available at https://github.com/ljy0ustc/PatchRec.

Despite the significant demand for assistive technology among vulnerable groups (e.g., the elderly, children, and the disabled) in daily tasks, research into advanced AI-driven assistive solutions that genuinely accommodate their diverse needs remains sparse. Traditional human-machine interaction tasks often require machines to simply help without nuanced consideration of human abilities and feelings, such as their opportunity for practice and learning, sense of self-improvement, and self-esteem. Addressing this gap, we define a pivotal and novel challenge Smart Help, which aims to provide proactive yet adaptive support to human agents with diverse disabilities and dynamic goals in various tasks and environments. To establish this challenge, we leverage AI2-THOR to build a new interactive 3D realistic household environment for the Smart Help task. We introduce an innovative opponent modeling module that provides a nuanced understanding of the main agent's capabilities and goals, in order to optimize the assisting agent's helping policy. Rigorous experiments validate the efficacy of our model components and show the superiority of our holistic approach against established baselines. Our findings illustrate the potential of AI-imbued assistive robots in improving the well-being of vulnerable groups.

LLM companions are deployed at scale in personally consequential settings, yet poorly evaluated. Existing benchmarks use hand-authored scenarios and prompted simulators, aggregate empathy into one score, and overlook judge biases such as same-family favoritism and scale drift. We introduce CompanionBench, an interactive bilingual benchmark. To our knowledge, it is the first companion benchmark to ground both its scenarios and a trained user simulator in de-identified real-world data. A hidden disclosure gate branches each persona's trajectory on the agent's own behavior, controlling the interaction state space without scripting dialogue. We operationalize ten capabilities derived from 25 theories across psychology and counseling, four of them not graded explicitly by prior work: holding ambiguity, selfobject responsiveness, positive resonance and calibrated challenge. Agents are assessed on two complementary axes: a subjective ten-capability rubric and a deterministic measure of whether deeper disclosure was earned. A cross-family panel dilutes same-family favoritism; an Item Response Theory model separates agent quality from judge severity. Theory fixes what to measure and how personas are structured; real data supply events, history, and profiles -- coverage from theory, authenticity from data. Rankings are reproducible in both languages (rho = 0.996 ZH / 0.953 EN). Evaluating 28 agents reveals capability-level differences obscured by aggregate scores. Emotion regulation and calibrated challenge remain common weaknesses; holding ambiguity discriminates most. Role-play agents rank near the bottom: immersion does not imply relational competence. Across agents, the dominant failure mode is substituting surface warmth for substantive relational support. We will release 500 Chinese-English parallel pairs and the evaluation code.

Large language model (LLM) powered chatbots are primarily text-based today, and impose a large interactional cognitive load, especially for exploratory or sensemaking tasks such as planning a trip or learning about a new city. Because the interaction is textual, users have little scaffolding in the way of structure, informational "scent", or ability to specify high-level preferences or goals. We introduce ExploreLLM that allows users to structure thoughts, help explore different options, navigate through the choices and recommendations, and to more easily steer models to generate more personalized responses. We conduct a user study and show that users find it helpful to use ExploreLLM for exploratory or planning tasks, because it provides a useful schema-like structure to the task, and guides users in planning. The study also suggests that users can more easily personalize responses with high-level preferences with ExploreLLM. Together, ExploreLLM points to a future where users interact with LLMs beyond the form of chatbots, and instead designed to support complex user tasks with a tighter integration between natural language and graphical user interfaces.

Combination therapies have become the standard of care for diseases such as cancer, tuberculosis, malaria and HIV. However, the combinatorial set of available multi-drug treatments creates a challenge in identifying effective combination therapies available in a situation. To assist medical professionals in identifying beneficial drug-combinations, we construct an expert-annotated dataset for extracting information about the efficacy of drug combinations from the scientific literature. Beyond its practical utility, the dataset also presents a unique NLP challenge, as the first relation extraction dataset consisting of variable-length relations. Furthermore, the relations in this dataset predominantly require language understanding beyond the sentence level, adding to the challenge of this task. We provide a promising baseline model and identify clear areas for further improvement. We release our dataset, code, and baseline models publicly to encourage the NLP community to participate in this task.

From the Specific-MLLM, which excels in single-modal tasks, to the Omni-MLLM, which extends the range of general modalities, this evolution aims to achieve understanding and generation of multimodal information. Omni-MLLM treats the features of different modalities as different "foreign languages," enabling cross-modal interaction and understanding within a unified space. To promote the advancement of related research, we have compiled 47 relevant papers to provide the community with a comprehensive introduction to Omni-MLLM. We first explain the four core components of Omni-MLLM for unified modeling and interaction of multiple modalities. Next, we introduce the effective integration achieved through "alignment pretraining" and "instruction fine-tuning," and discuss open-source datasets and testing of interaction capabilities. Finally, we summarize the main challenges facing current Omni-MLLM and outline future directions.

This paper presents TAMUSA-Chat, a research-oriented framework for building domain-adapted large language model conversational systems. The work addresses critical challenges in adapting general-purpose foundation models to institutional contexts through supervised fine-tuning, retrieval-augmented generation, and systematic evaluation methodologies. We describe the complete architecture encompassing data acquisition from institutional sources, preprocessing pipelines, embedding construction, model training workflows, and deployment strategies. The system integrates modular components enabling reproducible experimentation with training configurations, hyper-parameters, and evaluation protocols. Our implementation demonstrates how academic institutions can develop contextually grounded conversational agents while maintaining transparency, governance compliance, and responsible AI practices. Through empirical analysis of fine-tuning behavior across model sizes and training iterations, we provide insights into domain adaptation efficiency, computational resource requirements, and quality-cost trade-offs. The publicly available codebase at https://github.com/alsmadi/TAMUSA_LLM_Based_Chat_app supports continued research into institutional LLM deployment, evaluation methodologies, and ethical considerations for educational AI systems.

Despite the prevalence of sleep-tracking devices, many individuals struggle to translate data into actionable improvements in sleep health. Current methods often provide data-driven suggestions but may not be feasible and adaptive to real-life constraints and individual contexts. We present HealthGuru, a novel large language model-powered chatbot to enhance sleep health through data-driven, theory-guided, and adaptive recommendations with conversational behavior change support. HealthGuru's multi-agent framework integrates wearable device data, contextual information, and a contextual multi-armed bandit model to suggest tailored sleep-enhancing activities. The system facilitates natural conversations while incorporating data-driven insights and theoretical behavior change techniques. Our eight-week in-the-wild deployment study with 16 participants compared HealthGuru to a baseline chatbot. Results show improved metrics like sleep duration and activity scores, higher quality responses, and increased user motivation for behavior change with HealthGuru. We also identify challenges and design considerations for personalization and user engagement in health chatbots.

Using large language models (LLMs) to assist psychological counseling is a significant but challenging task at present. Attempts have been made on improving empathetic conversations or acting as effective assistants in the treatment with LLMs. However, the existing datasets lack consulting knowledge, resulting in LLMs lacking professional consulting competence. Moreover, how to automatically evaluate multi-turn dialogues within the counseling process remains an understudied area. To bridge the gap, we propose CPsyCoun, a report-based multi-turn dialogue reconstruction and evaluation framework for Chinese psychological counseling. To fully exploit psychological counseling reports, a two-phase approach is devised to construct high-quality dialogues while a comprehensive evaluation benchmark is developed for the effective automatic evaluation of multi-turn psychological consultations. Competitive experimental results demonstrate the effectiveness of our proposed framework in psychological counseling. We open-source the datasets and model for future research at https://github.com/CAS-SIAT-XinHai/CPsyCoun

The integration of Monte Carlo Tree Search (MCTS) with Large Language Models (LLMs) has demonstrated significant success in structured, problem-oriented tasks. However, applying these methods to open-ended dialogues, such as those in psychological counseling, presents unique challenges. Unlike tasks with objective correctness, success in therapeutic conversations depends on subjective factors like empathetic engagement, ethical adherence, and alignment with human preferences, for which strict "correctness" criteria are ill-defined. Existing result-oriented MCTS approaches can therefore produce misaligned responses. To address this, we introduce MCTSr-Zero, an MCTS framework designed for open-ended, human-centric dialogues. Its core innovation is "domain alignment", which shifts the MCTS search objective from predefined end-states towards conversational trajectories that conform to target domain principles (e.g., empathy in counseling). Furthermore, MCTSr-Zero incorporates "Regeneration" and "Meta-Prompt Adaptation" mechanisms to substantially broaden exploration by allowing the MCTS to consider fundamentally different initial dialogue strategies. We evaluate MCTSr-Zero in psychological counseling by generating multi-turn dialogue data, which is used to fine-tune an LLM, PsyLLM. We also introduce PsyEval, a benchmark for assessing multi-turn psychological counseling dialogues. Experiments demonstrate that PsyLLM achieves state-of-the-art performance on PsyEval and other relevant metrics, validating MCTSr-Zero's effectiveness in generating high-quality, principle-aligned conversational data for human-centric domains and addressing the LLM challenge of consistently adhering to complex psychological standards.

Existing Multimodal Large Language Models (MLLMs) remain primarily reactive, failing to continuously perceive environments or proactively assist users. While emerging benchmarks address proactivity, they are largely confined to alert scenarios, neglect personalized context, and fail to evaluate the precise timing of human-machine interactions (HMI).In this paper, we introduce EgoPro-Bench, a novel benchmark for training and evaluating proactive interaction capabilities based on streaming egocentric videos; it comprises 2,400 videos in the evaluation set and over 12,000 videos in the training set.Unlike previous works, EgoPro-Bench leverages simulated user profiles to generate diverse user intentions and to construct high-fidelity HMI data across 12 distinct domains.Subsequently, we propose a specialized evaluation protocol and metrics, train proactive interaction models designed for efficient reasoning and low-latency interaction on streaming video data, and conduct comprehensive evaluations.Furthermore, we introduce an interaction principle termed "short thinking, better interaction", which allocates a limited token budget prior to intent recognition, thereby enhancing interaction performance.The experiments demonstrate that EgoPro-Bench substantially enhances the intention understanding capabilities of MLLMs and enables accurate identification of appropriate timings for HMI, thereby laying a solid foundation for next-generation user-centric proactive interactive agents.

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

Most language-based assistants follow a reactive ask-and-respond paradigm, requiring users to explicitly state their needs. As a result, relevant but unexpressed needs often go unmet. Existing proactive agents attempt to address this gap either by eliciting further clarification, preserving this burden, or by extrapolating future needs from context, often leading to unnecessary or mistimed interventions. We introduce ProPer, Proactivity-driven Personalized agents, a novel two-agent architecture consisting of a Dimension Generating Agent (DGA) and a Response Generating Agent (RGA). DGA, a fine-tuned LLM agent, leverages explicit user data to generate multiple implicit dimensions (latent aspects relevant to the user's task but not considered by the user) or knowledge gaps. These dimensions are selectively filtered using a reranker based on quality, diversity, and task relevance. RGA then balances explicit and implicit dimensions to tailor personalized responses with timely and proactive interventions. We evaluate ProPer across multiple domains using a structured, gap-aware rubric that measures coverage, initiative appropriateness, and intent alignment. Our results show that ProPer improves quality scores and win rates across all domains, achieving up to 84% gains in single-turn evaluation and consistent dominance in multi-turn interactions.

Large language models (LLMs) achieve remarkable success in natural language processing (NLP). In practical scenarios like recommendations, as users increasingly seek personalized experiences, it becomes crucial to incorporate user interaction history into the context of LLMs to enhance personalization. However, from a practical utility perspective, user interactions' extensive length and noise present challenges when used directly as text prompts. A promising solution is to compress and distill interactions into compact embeddings, serving as soft prompts to assist LLMs in generating personalized responses. Although this approach brings efficiency, a critical concern emerges: Can user embeddings adequately capture valuable information and prompt LLMs? To address this concern, we propose \name, a benchmark designed to evaluate the effectiveness of user embeddings in prompting LLMs for personalization. We establish a fair and standardized evaluation process, encompassing pre-training, fine-tuning, and evaluation stages. To thoroughly evaluate user embeddings, we design three dimensions of tasks: sequence understanding, action prediction, and interest perception. These evaluation tasks cover the industry's demands in traditional recommendation tasks, such as improving prediction accuracy, and its aspirations for LLM-based methods, such as accurately understanding user interests and enhancing the user experience. We conduct extensive experiments on various state-of-the-art methods for modeling user embeddings. Additionally, we reveal the scaling laws of leveraging user embeddings to prompt LLMs. The benchmark is available online.

The emergence of advanced reasoning capabilities in Large Language Models (LLMs) marks a transformative development in healthcare applications. Beyond merely expanding functional capabilities, these reasoning mechanisms enhance decision transparency and explainability-critical requirements in medical contexts. This survey examines the transformation of medical LLMs from basic information retrieval tools to sophisticated clinical reasoning systems capable of supporting complex healthcare decisions. We provide a thorough analysis of the enabling technological foundations, with a particular focus on specialized prompting techniques like Chain-of-Thought and recent breakthroughs in Reinforcement Learning exemplified by DeepSeek-R1. Our investigation evaluates purpose-built medical frameworks while also examining emerging paradigms such as multi-agent collaborative systems and innovative prompting architectures. The survey critically assesses current evaluation methodologies for medical validation and addresses persistent challenges in field interpretation limitations, bias mitigation strategies, patient safety frameworks, and integration of multimodal clinical data. Through this survey, we seek to establish a roadmap for developing reliable LLMs that can serve as effective partners in clinical practice and medical research.

Large language models (LLMs) have demonstrated remarkable performance on single-turn text-to-SQL tasks, but real-world database applications predominantly require multi-turn interactions to handle ambiguous queries, execution errors, and evolving user requirements. Existing multi-turn benchmarks fall short by treating conversation histories as static context or limiting evaluation to read-only operations, failing to reflect production-grade database assistant challenges. We introduce BIRD-INTERACT, a benchmark that restores this realism through: (1) a comprehensive interaction environment coupling each database with a hierarchical knowledge base, metadata files, and a function-driven user simulator, enabling models to solicit clarifications, retrieve knowledge, and recover from errors without human supervision; (2) two evaluation settings consisting of a pre-defined conversational protocol (c-Interact) and an open-ended agentic setting (a-Interact) where models autonomously decide when to query the user simulator or explore the environment; (3) a challenging task suite covering the full CRUD spectrum for business-intelligence and operational use cases, guarded by executable test cases. Each task features ambiguous and follow-up sub-tasks requiring dynamic interaction. The suite comprises BIRD-INTERACT-FULL (600 tasks, up to 11,796 interactions) for comprehensive performance assessment, and BIRD-INTERACT-LITE (300 tasks with simplified databases) for detailed behavioral analysis and rapid method development. Our empirical results highlight BIRD-INTERACT's difficulty: GPT-5 completes only 8.67% of tasks in c-Interact and 17.00% in a-Interact. Analysis via memory grafting and Interaction Test-time Scaling validates the importance of effective interaction for complex, dynamic text-to-SQL tasks.

Large Language Models (LLMs) are increasingly utilized for mental health support; however, current safety benchmarks often fail to detect the complex, longitudinal risks inherent in therapeutic dialogue. We introduce an evaluation framework that pairs AI psychotherapists with simulated patient agents equipped with dynamic cognitive-affective models and assesses therapy session simulations against a comprehensive quality of care and risk ontology. We apply this framework to a high-impact test case, Alcohol Use Disorder, evaluating six AI agents (including ChatGPT, Gemini, and Character.AI) against a clinically-validated cohort of 15 patient personas representing diverse clinical phenotypes. Our large-scale simulation (N=369 sessions) reveals critical safety gaps in the use of AI for mental health support. We identify specific iatrogenic risks, including the validation of patient delusions ("AI Psychosis") and failure to de-escalate suicide risk. Finally, we validate an interactive data visualization dashboard with diverse stakeholders, including AI engineers and red teamers, mental health professionals, and policy experts (N=9), demonstrating that this framework effectively enables stakeholders to audit the "black box" of AI psychotherapy. These findings underscore the critical safety risks of AI-provided mental health support and the necessity of simulation-based clinical red teaming before deployment.

Interactive Natural Language Processing (iNLP) has emerged as a novel paradigm within the field of NLP, aimed at addressing limitations in existing frameworks while aligning with the ultimate goals of artificial intelligence. This paradigm considers language models as agents capable of observing, acting, and receiving feedback iteratively from external entities. Specifically, language models in this context can: (1) interact with humans for better understanding and addressing user needs, personalizing responses, aligning with human values, and improving the overall user experience; (2) interact with knowledge bases for enriching language representations with factual knowledge, enhancing the contextual relevance of responses, and dynamically leveraging external information to generate more accurate and informed responses; (3) interact with models and tools for effectively decomposing and addressing complex tasks, leveraging specialized expertise for specific subtasks, and fostering the simulation of social behaviors; and (4) interact with environments for learning grounded representations of language, and effectively tackling embodied tasks such as reasoning, planning, and decision-making in response to environmental observations. This paper offers a comprehensive survey of iNLP, starting by proposing a unified definition and framework of the concept. We then provide a systematic classification of iNLP, dissecting its various components, including interactive objects, interaction interfaces, and interaction methods. We proceed to delve into the evaluation methodologies used in the field, explore its diverse applications, scrutinize its ethical and safety issues, and discuss prospective research directions. This survey serves as an entry point for researchers who are interested in this rapidly evolving area and offers a broad view of the current landscape and future trajectory of iNLP.

This paper presents InteractEdit, a novel framework for zero-shot Human-Object Interaction (HOI) editing, addressing the challenging task of transforming an existing interaction in an image into a new, desired interaction while preserving the identities of the subject and object. Unlike simpler image editing scenarios such as attribute manipulation, object replacement or style transfer, HOI editing involves complex spatial, contextual, and relational dependencies inherent in humans-objects interactions. Existing methods often overfit to the source image structure, limiting their ability to adapt to the substantial structural modifications demanded by new interactions. To address this, InteractEdit decomposes each scene into subject, object, and background components, then employs Low-Rank Adaptation (LoRA) and selective fine-tuning to preserve pretrained interaction priors while learning the visual identity of the source image. This regularization strategy effectively balances interaction edits with identity consistency. We further introduce IEBench, the most comprehensive benchmark for HOI editing, which evaluates both interaction editing and identity preservation. Our extensive experiments show that InteractEdit significantly outperforms existing methods, establishing a strong baseline for future HOI editing research and unlocking new possibilities for creative and practical applications. Code will be released upon publication.

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

Despite rapid progress in autonomous web agents, human involvement remains essential for shaping preferences and correcting agent behavior as tasks unfold. However, current agentic systems lack a principled understanding of when and why humans intervene, often proceeding autonomously past critical decision points or requesting unnecessary confirmation. In this work, we introduce the task of modeling human intervention to support collaborative web task execution. We collect CowCorpus, a dataset of 400 real-user web navigation trajectories containing over 4,200 interleaved human and agent actions. We identify four distinct patterns of user interaction with agents -- hands-off supervision, hands-on oversight, collaborative task-solving, and full user takeover. Leveraging these insights, we train language models (LMs) to anticipate when users are likely to intervene based on their interaction styles, yielding a 61.4-63.4% improvement in intervention prediction accuracy over base LMs. Finally, we deploy these intervention-aware models in live web navigation agents and evaluate them in a user study, finding a 26.5% increase in user-rated agent usefulness. Together, our results show structured modeling of human intervention leads to more adaptive, collaborative agents.

Large Language Models have demonstrated profound utility in the medical domain. However, their application to autonomous Electronic Health Records~(EHRs) navigation remains constrained by a reliance on curated inputs and simplified retrieval tasks. To bridge the gap between idealized experimental settings and realistic clinical environments, we present AgentEHR. This benchmark challenges agents to execute complex decision-making tasks, such as diagnosis and treatment planning, requiring long-range interactive reasoning directly within raw and high-noise databases. In tackling these tasks, we identify that existing summarization methods inevitably suffer from critical information loss and fractured reasoning continuity. To address this, we propose RetroSum, a novel framework that unifies a retrospective summarization mechanism with an evolving experience strategy. By dynamically re-evaluating interaction history, the retrospective mechanism prevents long-context information loss and ensures unbroken logical coherence. Additionally, the evolving strategy bridges the domain gap by retrieving accumulated experience from a memory bank. Extensive empirical evaluations demonstrate that RetroSum achieves performance gains of up to 29.16% over competitive baselines, while significantly decreasing total interaction errors by up to 92.3%.

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.

Creating interactive scenes often involves complex programming tasks. Although large language models (LLMs) like ChatGPT can generate code from natural language, their output is often error-prone, particularly when scripting interactions among multiple elements. The linear conversational structure limits the editing of individual elements, and lacking graphical and precise control complicates visual integration. To address these issues, we integrate an element-level modularization technique that processes textual descriptions for individual elements through separate LLM modules, with a central module managing interactions among elements. This modular approach allows for refining each element independently. We design a graphical user interface, MoGraphGPT , which combines modular LLMs with enhanced graphical control to generate codes for 2D interactive scenes. It enables direct integration of graphical information and offers quick, precise control through automatically generated sliders. Our comparative evaluation against an AI coding tool, Cursor Composer, as the baseline system and a usability study show MoGraphGPT significantly improves easiness, controllability, and refinement in creating complex 2D interactive scenes with multiple visual elements in a coding-free manner.