Daily Papers

Large language models with Mixture-of-Experts (MoE) architectures achieve efficiency and scalability, yet their routing mechanisms introduce safety alignment challenges insufficiently addressed by techniques developed for dense models. In this work, the MoE-specific safety risk of positional vulnerability-that safety-aligned behaviors rely on specific expert modules-is formalized and systematically analyzed. An analytical framework, SAFEx, is presented to robustly identify, characterize, and validate safety-critical experts via a stability-based expert selection procedure, and to decompose them into two functional groups: the Harmful Content Detection Group (HCDG), which specializes in identifying and recognizing harmful content within user inputs, and the Harmful Response Control Group (HRCG), which specializes in controlling and enforcing model behaviors to generate appropriate safety responses. Expert-level interventions are conducted to probe causality and to test mitigation. Targeted masking of SAFEx-selected experts reveals that safety behavior is highly concentrated. On Qwen3-30B-A3B, configured with 48 MoE-FFN layers and 128 experts per layer under top-8 routing (48x128=6,144 experts in total), disabling 12 selected experts reduces the refusal rate by 22%. In addition, lightweight adaptation is performed using LoRA under three configurations-the HRCG, the union of HCDG and HRCG, and all experts-and the resulting updates are composed through negative weight merging targeted at the HRCG, leading to improved refusal under adversarial prompts without full-model retraining. These results establish positional vulnerability as a distinct MoE-specific safety challenge and provide a practical, compute-efficient pathway for expert-level safety interventions within routed architectures.

During the COVID-19 pandemic, a significant effort has gone into developing ML-driven epidemic forecasting techniques. However, benchmarks do not exist to claim if a new AI/ML technique is better than the existing ones. The "covid-forecast-hub" is a collection of more than 30 teams, including us, that submit their forecasts weekly to the CDC. It is not possible to declare whether one method is better than the other using those forecasts because each team's submission may correspond to different techniques over the period and involve human interventions as the teams are continuously changing/tuning their approach. Such forecasts may be considered "human-expert" forecasts and do not qualify as AI/ML approaches, although they can be used as an indicator of human expert performance. We are interested in supporting AI/ML research in epidemic forecasting which can lead to scalable forecasting without human intervention. Which modeling technique, learning strategy, and data pre-processing technique work well for epidemic forecasting is still an open problem. To help advance the state-of-the-art AI/ML applied to epidemiology, a benchmark with a collection of performance points is needed and the current "state-of-the-art" techniques need to be identified. We propose EpiBench a platform consisting of community-driven benchmarks for AI/ML applied to epidemic forecasting to standardize the challenge with a uniform evaluation protocol. In this paper, we introduce a prototype of EpiBench which is currently running and accepting submissions for the task of forecasting COVID-19 cases and deaths in the US states and We demonstrate that we can utilize the prototype to develop an ensemble relying on fully automated epidemic forecasts (no human intervention) that reaches human-expert level ensemble currently being used by the CDC.

Mixture-of-Experts (MoE) language models are universally sensitive to demographic content at the routing level, yet exploiting this sensitivity for fairness control is structurally limited. We introduce Fairness-Aware Routing Equilibrium (FARE), a diagnostic framework designed to probe the limits of routing-level stereotype intervention across diverse MoE architectures. FARE reveals that routing-level preference shifts are either unachievable (Mixtral, Qwen1.5, Qwen3), statistically non-robust (DeepSeekMoE), or accompanied by substantial utility cost (OLMoE, -4.4%p CrowS-Pairs at -6.3%p TQA). Critically, even where log-likelihood preference shifts are robust, they do not transfer to decoded generation: expanded evaluations on both non-null models yield null results across all generation metrics. Group-level expert masking reveals why: bias and core knowledge are deeply entangled within expert groups. These findings indicate that routing sensitivity is necessary but insufficient for stereotype control, and identify specific architectural conditions that can inform the design of more controllable future MoE systems.

Domain expertise enhances judgment within boundaries but creates systematic vulnerabilities specifically at borders. We term this Transitive Expert Error (TEE), distinct from Dunning-Kruger effects, requiring calibrated expertise as precondition. Mechanisms enabling reliable within-domain judgment become liabilities when structural similarity masks causal divergence. Two core mechanisms operate: structural similarity bias causes experts to overweight surface features (shared vocabulary, patterns, formal structure) while missing causal architecture differences; authority persistence maintains confidence across competence boundaries through social reinforcement and metacognitive failures (experts experience no subjective uncertainty as pattern recognition operates smoothly on familiar-seeming inputs.) These mechanism intensify under three conditions: shared vocabulary masking divergent processes, social pressure for immediate judgment, and delayed feedback. These findings extend to AI routing architectures (MoE systems, multi-model orchestration, tool-using agents, RAG systems) exhibiting routing-induced failures (wrong specialist selected) and coverage-induced failures (no appropriate specialist exists). Both produce a hallucination phenotype: confident, coherent, structurally plausible but causally incorrect outputs at domain boundaries. In human systems where mechanisms are cognitive black boxes; AI architectures make them explicit and addressable. We propose interventions: multi-expert activation with disagreement detection (router level), boundary-aware calibration (specialist level), and coverage gap detection (training level). TEE has detectable signatures (routing patterns, confidence-accuracy dissociations, domain-inappropriate content) enabling monitoring and mitigation. What remains intractable in human cognition becomes addressable through architectural design.

Despite their widespread use, Large Language Models (LLMs) remain limited by a fundamental problem: the generation of plausible but false content, known as hallucinations. Most existing detection methods operate at the answer or sentence level, yet per-token detection is essential for localizing hallucinated spans and enabling fine-grained interventions. In this paper, we explore the use of the Mixture-of-Experts (MoE) paradigm to address this gap. In MoE architectures, a single forward pass activates a sparse subset of experts (i.e., distinct feedforward networks per layer) via a routing mechanism, producing internal signals (e.g., router entropy, expert disagreement, and expert usage patterns) that are unavailable in dense architectures and have not been previously exploited for hallucination detection. To this end, we introduce InnerExpert, the first method to leverage these MoE-specific signals for per-token hallucination detection. InnerExpert combines routing-level and standard transformer signals into compact per-token feature vectors, classified by a lightweight detector trained on labels produced by an LLM-as-a-judge pipeline, which enables continuous model updates without manual annotation. Our results show that InnerExpert outperforms existing methods across five datasets and two MoE architectures, achieving up to 0.91 answer-level and 0.76 token-level AUROC, while requiring only a single forward pass.

The Mixture of Experts (MoE) paradigm provides a powerful way to decompose inscrutable dense layers into smaller, modular computations often more amenable to human interpretation, debugging, and editability. A major problem however lies in the computational cost of scaling the number of experts to achieve sufficiently fine-grained specialization. In this paper, we propose the Multilinear Mixutre of Experts (MMoE) layer to address this, focusing on vision models. MMoE layers perform an implicit computation on prohibitively large weight tensors entirely in factorized form. Consequently, MMoEs both (1) avoid the issues incurred through the discrete expert routing in the popular 'sparse' MoE models, yet (2) do not incur the restrictively high inference-time costs of 'soft' MoE alternatives. We present both qualitative and quantitative evidence (through visualization and counterfactual interventions respectively) that scaling MMoE layers when fine-tuning foundation models for vision tasks leads to more specialized experts at the class-level whilst remaining competitive with the performance of parameter-matched linear layer counterparts. Finally, we show that learned expert specialism further facilitates manual correction of demographic bias in CelebA attribute classification. Our MMoE model code is available at https://github.com/james-oldfield/MMoE.

Decision-makers are often experts of their domain and take actions based on their domain knowledge. Doctors, for instance, may prescribe treatments by predicting the likely outcome of each available treatment. Actions of an expert thus naturally encode part of their domain knowledge, and can help make inferences within the same domain: Knowing doctors try to prescribe the best treatment for their patients, we can tell treatments prescribed more frequently are likely to be more effective. Yet in machine learning, the fact that most decision-makers are experts is often overlooked, and "expertise" is seldom leveraged as an inductive bias. This is especially true for the literature on treatment effect estimation, where often the only assumption made about actions is that of overlap. In this paper, we argue that expertise - particularly the type of expertise the decision-makers of a domain are likely to have - can be informative in designing and selecting methods for treatment effect estimation. We formally define two types of expertise, predictive and prognostic, and demonstrate empirically that: (i) the prominent type of expertise in a domain significantly influences the performance of different methods in treatment effect estimation, and (ii) it is possible to predict the type of expertise present in a dataset, which can provide a quantitative basis for model selection.

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.

Concept bottleneck models (CBMs) are a class of interpretable neural network models that predict the target response of a given input based on its high-level concepts. Unlike the standard end-to-end models, CBMs enable domain experts to intervene on the predicted concepts and rectify any mistakes at test time, so that more accurate task predictions can be made at the end. While such intervenability provides a powerful avenue of control, many aspects of the intervention procedure remain rather unexplored. In this work, we develop various ways of selecting intervening concepts to improve the intervention effectiveness and conduct an array of in-depth analyses as to how they evolve under different circumstances. Specifically, we find that an informed intervention strategy can reduce the task error more than ten times compared to the current baseline under the same amount of intervention counts in realistic settings, and yet, this can vary quite significantly when taking into account different intervention granularity. We verify our findings through comprehensive evaluations, not only on the standard real datasets, but also on synthetic datasets that we generate based on a set of different causal graphs. We further discover some major pitfalls of the current practices which, without a proper addressing, raise concerns on reliability and fairness of the intervention procedure.

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

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.

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

Experts advising decision-makers are likely to display expertise which varies as a function of the problem instance. In practice, this may lead to sub-optimal or discriminatory decisions against minority cases. In this work we model such changes in depth and breadth of knowledge as a partitioning of the problem space into regions of differing expertise. We provide here new algorithms that explicitly consider and adapt to the relationship between problem instances and experts' knowledge. We first propose and highlight the drawbacks of a naive approach based on nearest neighbor queries. To address these drawbacks we then introduce a novel algorithm - expertise trees - that constructs decision trees enabling the learner to select appropriate models. We provide theoretical insights and empirically validate the improved performance of our novel approach on a range of problems for which existing methods proved to be inadequate.

Test-time interventions for language models can enhance factual accuracy, mitigate harmful outputs, and improve model efficiency without costly retraining. But despite a flood of new methods, different types of interventions are largely developing independently. In practice, multiple interventions must be applied sequentially to the same model, yet we lack standardized ways to study how interventions interact. We fill this gap by introducing composable interventions, a framework to study the effects of using multiple interventions on the same language models, featuring new metrics and a unified codebase. Using our framework, we conduct extensive experiments and compose popular methods from three emerging intervention categories -- Knowledge Editing, Model Compression, and Machine Unlearning. Our results from 310 different compositions uncover meaningful interactions: compression hinders editing and unlearning, composing interventions hinges on their order of application, and popular general-purpose metrics are inadequate for assessing composability. Taken together, our findings showcase clear gaps in composability, suggesting a need for new multi-objective interventions. All of our code is public: https://github.com/hartvigsen-group/composable-interventions.

Despite advances in AI's performance and interpretability, AI advisors can undermine experts' decisions and increase the time and effort experts must invest to make decisions. Consequently, AI systems deployed in high-stakes settings often fail to consistently add value across contexts and can even diminish the value that experts alone provide. Beyond harm in specific domains, such outcomes impede progress in research and practice, underscoring the need to understand when and why different AI advisors add or diminish value. To bridge this gap, we stress the importance of assessing the value AI advice brings to real-world contexts when designing and evaluating AI advisors. Building on this perspective, we characterize key pillars -- pathways through which AI advice impacts value -- and develop a framework that incorporates these pillars to create reliable, personalized, and value-adding advisors. Our results highlight the need for system-level, value-driven development of AI advisors that advise selectively, are tailored to experts' unique behaviors, and are optimized for context-specific trade-offs between decision improvements and advising costs. They also reveal how the lack of inclusion of these pillars in the design of AI advising systems may be contributing to the failures observed in practical applications.

When deployed in the real world, AI agents will inevitably face challenges that exceed their individual capabilities. Leveraging assistance from experts, whether humans or highly capable AI systems, can significantly improve both safety and performance in such situations. Since expert assistance is costly, a central challenge is determining when to consult an expert. In this paper, we explore a novel variant of this problem, termed YRC-0, in which an agent must learn to collaborate with an expert in new environments in an unsupervised manner--that is, without interacting with the expert during training. This setting motivates the development of low-cost, robust approaches for training expert-leveraging agents. To support research in this area, we introduce YRC-Bench, an open-source benchmark that instantiates YRC-0 across diverse environments. YRC-Bench provides a standardized Gym-like API, simulated experts, an evaluation pipeline, and implementations of popular baselines. Toward tackling YRC-0, we propose a validation strategy and evaluate a range of learning methods, offering insights that can inform future research. Codebase: github.com/modanesh/YRC-Bench

Expert persona prompting -- assigning roles such as expert in math to language models -- is widely used for task improvement. However, prior work shows mixed results on its effectiveness, and does not consider when and why personas should improve performance. We analyze the literature on persona prompting for task improvement and distill three desiderata: 1) performance advantage of expert personas, 2) robustness to irrelevant persona attributes, and 3) fidelity to persona attributes. We then evaluate 9 state-of-the-art LLMs across 27 tasks with respect to these desiderata. We find that expert personas usually lead to positive or non-significant performance changes. Surprisingly, models are highly sensitive to irrelevant persona details, with performance drops of almost 30 percentage points. In terms of fidelity, we find that while higher education, specialization, and domain-relatedness can boost performance, their effects are often inconsistent or negligible across tasks. We propose mitigation strategies to improve robustness -- but find they only work for the largest, most capable models. Our findings underscore the need for more careful persona design and for evaluation schemes that reflect the intended effects of persona usage.

An important issue with Large Language Models (LLMs) is their undesired ability to generate toxic language. In this work, we show that the neurons responsible for toxicity can be determined by their power to discriminate toxic sentences, and that toxic language can be mitigated by reducing their activation levels proportionally to this power. We propose AUROC adaptation (AurA), an intervention that can be applied to any pre-trained LLM to mitigate toxicity. As the intervention is proportional to the ability of each neuron to discriminate toxic content, it is free of any model-dependent hyperparameters. We show that AurA can achieve up to 2.2 times reduction in toxicity with only a 0.72 perplexity increase. We also show that AurA is effective with models of different scale (from 1.5B to 40B parameters), and its effectiveness in mitigating toxic language, while preserving common-sense zero-shot abilities, holds across all scales. AurA can be combined with pre-prompting strategies, boosting its average mitigation potential from 1.28times to 2.35times. Moreover, AurA can counteract adversarial pre-prompts that maliciously elicit toxic content, making it an effective method for deploying safer and less toxic models.

We present Multi-expert Prompting, a novel enhancement of ExpertPrompting (Xu et al., 2023), designed to improve the large language model (LLM) generation. Specifically, it guides an LLM to fulfill an input instruction by simulating multiple experts, aggregating their responses, and selecting the best among individual and aggregated responses. This process is performed in a single chain of thoughts through our seven carefully designed subtasks derived from the Nominal Group Technique (Ven and Delbecq, 1974), a well-established decision-making framework. Our evaluations demonstrate that Multi-expert Prompting significantly outperforms ExpertPrompting and comparable baselines in enhancing the truthfulness, factuality, informativeness, and usefulness of responses while reducing toxicity and hurtfulness. It further achieves state-of-the-art truthfulness by outperforming the best baseline by 8.69% with ChatGPT. Multi-expert Prompting is efficient, explainable, and highly adaptable to diverse scenarios, eliminating the need for manual prompt construction.

Mixture-of-Experts (MoE) language models route each token through a small subset of experts, making routing patterns useful for identifying task-relevant experts during downstream adaptation. Yet current approaches have two limitations: task experts are typically identified from aggregate routing statistics that reflect usage rather than association with successful task completion, and task-expert activations remain underexplored as signals for supervision allocation. We introduce Task-Expert-Aware Supervision (TEXAS), which combines correctness-conditioned task expert discovery with token-level supervision allocation. TEXAS compares expert activations on instances that the base model solves successfully and those it fails to solve, and retains experts more strongly activated on successful instances. During fine-tuning, it upweights answer tokens in failed instances when they activate these experts. TEXAS therefore leverages existing routing behavior without restricting adaptation to a fixed expert subset or imposing an explicit target routing distribution. Across three MoE models and six benchmarks, TEXAS achieves the best or tied-best performance in 17 of 18 settings and improves over the strongest baseline by 1.3--1.5 points on average. Ablations and further analyses validate both the discovered experts and the resulting supervision strategy.

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.

Navigating certain communication situations can be challenging due to individuals' lack of skills and the interference of strong emotions. However, effective learning opportunities are rarely accessible. In this work, we conduct a human-centered study that uses language models to simulate bespoke communication training and provide just-in-time feedback to support the practice and learning of interpersonal effectiveness skills. We apply the interpersonal effectiveness framework from Dialectical Behavioral Therapy (DBT), DEAR MAN, which focuses on both conversational and emotional skills. We present IMBUE, an interactive training system that provides feedback 25% more similar to experts' feedback, compared to that generated by GPT-4. IMBUE is the first to focus on communication skills and emotion management simultaneously, incorporate experts' domain knowledge in providing feedback, and be grounded in psychology theory. Through a randomized trial of 86 participants, we find that IMBUE's simulation-only variant significantly improves participants' self-efficacy (up to 17%) and reduces negative emotions (up to 25%). With IMBUE's additional just-in-time feedback, participants demonstrate 17% improvement in skill mastery, along with greater enhancements in self-efficacy (27% more) and reduction of negative emotions (16% more) compared to simulation-only. The improvement in skill mastery is the only measure that is transferred to new and more difficult situations; situation specific training is necessary for improving self-efficacy and emotion reduction.

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.

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.

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

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.

We present an automated, contrastive evaluation pipeline for auditing the behavioral impact of interventions on large language models. Given a base model M_1 and an intervention model M_2, our method compares their free-form, multi-token generations across aligned prompt contexts and produces human-readable, statistically validated natural-language hypotheses describing how the models differ, along with recurring themes that summarize patterns across validated hypotheses. We evaluate the approach in synthetic setting by injecting known behavioral changes and showing that the pipeline reliably recovers them. We then apply it to three real-world interventions, reasoning distillation, knowledge editing and unlearning, demonstrating that the method surfaces both intended and unexpected behavioral shifts, distinguishes large from subtle interventions, and does not hallucinate differences when effects are absent or misaligned with the prompt bank. Overall, the pipeline provides a statistically grounded and interpretable tool for post-hoc auditing of intervention-induced changes in model behavior.

Generative AI, particularly Language Models (LMs), has the potential to transform real-world domains with societal impact, particularly where access to experts is limited. For example, in education, training novice educators with expert guidance is important for effectiveness but expensive, creating significant barriers to improving education quality at scale. This challenge disproportionately harms students from under-served communities, who stand to gain the most from high-quality education. We introduce Tutor CoPilot, a novel Human-AI approach that leverages a model of expert thinking to provide expert-like guidance to tutors as they tutor. This study is the first randomized controlled trial of a Human-AI system in live tutoring, involving 900 tutors and 1,800 K-12 students from historically under-served communities. Following a preregistered analysis plan, we find that students working with tutors that have access to Tutor CoPilot are 4 percentage points (p.p.) more likely to master topics (p<0.01). Notably, students of lower-rated tutors experienced the greatest benefit, improving mastery by 9 p.p. We find that Tutor CoPilot costs only $20 per-tutor annually. We analyze 550,000+ messages using classifiers to identify pedagogical strategies, and find that tutors with access to Tutor CoPilot are more likely to use high-quality strategies to foster student understanding (e.g., asking guiding questions) and less likely to give away the answer to the student. Tutor interviews highlight how Tutor CoPilot's guidance helps tutors to respond to student needs, though they flag issues in Tutor CoPilot, such as generating suggestions that are not grade-level appropriate. Altogether, our study of Tutor CoPilot demonstrates how Human-AI systems can scale expertise in real-world domains, bridge gaps in skills and create a future where high-quality education is accessible to all students.

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.

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.

Providing high quality explanations for AI predictions based on machine learning is a challenging and complex task. To work well it requires, among other factors: selecting a proper level of generality/specificity of the explanation; considering assumptions about the familiarity of the explanation beneficiary with the AI task under consideration; referring to specific elements that have contributed to the decision; making use of additional knowledge (e.g. expert evidence) which might not be part of the prediction process; and providing evidence supporting negative hypothesis. Finally, the system needs to formulate the explanation in a clearly interpretable, and possibly convincing, way. Given these considerations, ANTIDOTE fosters an integrated vision of explainable AI, where low-level characteristics of the deep learning process are combined with higher level schemes proper of the human argumentation capacity. ANTIDOTE will exploit cross-disciplinary competences in deep learning and argumentation to support a broader and innovative view of explainable AI, where the need for high-quality explanations for clinical cases deliberation is critical. As a first result of the project, we publish the Antidote CasiMedicos dataset to facilitate research on explainable AI in general, and argumentation in the medical domain in particular.

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.

Agent Skills improve LLM agents by making task knowledge reusable across sessions. Learning transferable Skills requires evidence about a procedure and its conditions of use, which a successful task attempt can leave untested. We introduce Socratic Skill Learning (SSL), which interleaves expert teaching with Student practice. An Educator guides investigation while the Student remains the sole environment operator and Skill author, able to question, test, and adapt advice. To test reuse beyond the learning task, we construct SkillTransferBench, with 35 task families and 408 executable cases, pairing public variation specifications with held-out evaluation in fresh solver sessions. On the main 22-family, 155-case cohort, Fixed-Window SSL reaches 0.801 utility, versus 0.723 without a Skill, 0.761 for adapted Trace2Skill (trajectory distillation), and 0.751 for adapted SKILL-KD (contrastive distillation). Across three model pairs on shared families, interleaved guidance outperforms expert authoring and post-hoc teaching. Process analysis links guidance to Student writing and package revision; a case study shows the Student testing and refining a proposed procedure for later reuse. As demand for new lessons falls, the cost of fixed-window review grows. Issue-Guided SSL tracks unresolved questions across Skill revisions to select and focus review, reaching 0.805 utility with 61.7% fewer Educator tokens and 16.9% fewer total acquisition tokens than Fixed-Window SSL on the main cohort.

Psychiatric consultation requires agents to elicit discriminative evidence, map uncertain narratives to diagnostic criteria, and decide when evidence suffices. Existing dialogue and retrieval-augmented systems condition policies on raw histories or appended passages, leaving observed evidence, missing checks, differentials, and support reliability entangled. We introduce MIND, a criteria-grounded evidence-state decision interface. At each turn, MIND constructs a typed state containing observed evidence, unresolved criterion checks, active differentials, criterion-linked supports, and reliability metadata. A training-split Psychiatric Reasoning Bank supplies gated supports, turning retrieval into state construction rather than prompt injection. The same state conditions action selection, process rewards, information-gain scoring, and trajectory rectification. Under EMR-grounded simulator protocols, MIND improves accuracy by 8.8 and 7.3 points over strong inference-only, RAG, and RL baselines, with gains transferring to public MDD-5k dialogues. Matched interventions attribute these gains to the shared state rather than prompt length, retrieval text, or formatting. MIND targets screening-level decision support, not autonomous diagnosis. Code is available at https://github.com/Lingxi-mental-health/MIND.Å

Access to the right evidence does not guarantee that large language models (LLMs) will reason with it correctly. This gap between retrieval and reasoning is especially concerning in clinical settings, where outputs must align with structured protocols. We study this gap using Written Exposure Therapy (WET) guidelines as a testbed. In evaluating model responses to curated clinician-vetted questions, we find that errors persist even when authoritative passages are provided. To address this, we propose an evaluation framework that measures accuracy, consistency, and fidelity of reasoning. Our results highlight both the potential and the risks: retrieval-augmented generation (RAG) can constrain outputs, but safe deployment requires assessing reasoning as rigorously as retrieval.

Sparse mixture-of-experts (MoE) models expand parameter capacity by activating a small subset of experts per token. Expert selection directly affects model capabilities under a fixed active-expert budget. Dense evaluation of all experts reveals weak agreement between single-router rankings and expert-utility evaluation rankings, especially in middle and deep layers. Richer signals for selection and computation incur additional cost: selection based on internal expert activations requires preliminary computation, while processing multiple full representations separately through the same expert repeats its computation. We propose Multi-View MoE to improve expert selection with multiple routers and reuse their preferences to modulate expert computation under a fixed expert budget. Its Multi-Router submodule aggregates sigmoid scores from independently initialized routers. These routers develop highly differentiated expert preferences during training, allowing experts strongly favored by one router or jointly supported by several routers to be selected. Multi-View further uses each selected expert's relative scores across routers to mix learned latent views into its input, reusing routing preferences for both selection and computation. Each selected expert executes one forward pass, preserving the active-expert count, expert FLOPs, and all-to-all communication volume. On a 24-layer 10B-A1B model trained on 708B tokens, full Multi-View MoE improves the nine-task downstream mean by 1.18 percentage points over the baseline. Multi-Router alone yields a 0.6-percentage-point gain and improves the rank correlation between router scores and evaluated expert utility, with relative increases of 8.1% globally and approximately 58% in the layer with the lowest single-router alignment. Controlled mixing interventions show the model uses input differences that depend on both the expert and the token.

People increasingly use large language models (LLMs) for mental health support, yet their safety in evolving, high-risk conversations remains poorly characterised. We developed K-Bench, a clinician-calibrated, protected benchmark evaluating 125 model configurations representing 33 base models from 14 providers across a fixed cohort of 200 multi-turn vignettes involving suicide, self-harm, domestic violence, substance misuse, and no-risk presentations. Synthetic patient conversations showed substantial distributional overlap with real human-AI conversations. A frozen GPT-4o judge achieved 94.2% exact agreement with clinician consensus across 6,751 eligible item comparisons from 151 clinician-rated transcripts. Leading models combined strong supportive conversation with combined-risk scores above 95, whereas risk exploration exposed substantial variation among lower-performing configurations. Therapeutic prompting produced configuration-specific gains concentrated among weaker models, while elevated reasoning produced no average improvement. K-Bench combines broader clinical coverage and configuration-scale comparison with a continuously updated public leaderboard whose operational test materials are protected from direct optimisation. The leaderboard is available at www.k-bench.ai.

Systematic literature review is essential for evidence-based medicine, requiring comprehensive analysis of clinical trial publications. However, the application of artificial intelligence (AI) models for medical literature mining has been limited by insufficient training and evaluation across broad therapeutic areas and diverse tasks. Here, we present LEADS, an AI foundation model for study search, screening, and data extraction from medical literature. The model is trained on 633,759 instruction data points in LEADSInstruct, curated from 21,335 systematic reviews, 453,625 clinical trial publications, and 27,015 clinical trial registries. We showed that LEADS demonstrates consistent improvements over four cutting-edge generic large language models (LLMs) on six tasks. Furthermore, LEADS enhances expert workflows by providing supportive references following expert requests, streamlining processes while maintaining high-quality results. A study with 16 clinicians and medical researchers from 14 different institutions revealed that experts collaborating with LEADS achieved a recall of 0.81 compared to 0.77 experts working alone in study selection, with a time savings of 22.6%. In data extraction tasks, experts using LEADS achieved an accuracy of 0.85 versus 0.80 without using LEADS, alongside a 26.9% time savings. These findings highlight the potential of specialized medical literature foundation models to outperform generic models, delivering significant quality and efficiency benefits when integrated into expert workflows for medical literature mining.

Foundation models can serve as clinical agents through tool-use harnesses. However, conventional medical benchmarks assess reasoning over preselected evidence rather than the ability to seek it across clinical records and longitudinal imaging. We propose CASE: a series of role-specific Clinical Agents for Seeking Evidence, together with a tool-use harness and an agentic post-training framework for compact vision-language policy models. We further introduce a longitudinal multimodal benchmark built on UK Biobank, comprising 50,401 clinical questions derived from real-world ICD-10-coded diagnoses of 4,739 participants. Each question links to a patient-specific environment containing clinical context and multi-sequence MRI from baseline and follow-up visits, where agents autonomously select which visits, organs, modalities, slices, and specialist tools to inspect and compare. Supervised fine-tuning transfers evidence-seeking workflows from 14,734 frontier-model interaction trajectories, followed by agentic reinforcement learning on the learner's own environment interactions. Privileged on-policy self-distillation and rubric-based LLM feedback refine evidence-to-conclusion reasoning without prescribing tool sequences. Experiments show that CASE moves beyond question-answer imitation toward transferable investigation policies, strengthening evidence-grounded longitudinal reasoning. Under matched evaluation conditions, our Qwen3-VL-8B based agent achieves over 16% and 10% relative improvements in answer accuracy over GPT-5.4 and Claude Opus 4.8. Code will be available at https://github.com/VinyehShaw/CASE.

People supported by AI-powered decision support tools frequently overrely on the AI: they accept an AI's suggestion even when that suggestion is wrong. Adding explanations to the AI decisions does not appear to reduce the overreliance and some studies suggest that it might even increase it. Informed by the dual-process theory of cognition, we posit that people rarely engage analytically with each individual AI recommendation and explanation, and instead develop general heuristics about whether and when to follow the AI suggestions. Building on prior research on medical decision-making, we designed three cognitive forcing interventions to compel people to engage more thoughtfully with the AI-generated explanations. We conducted an experiment (N=199), in which we compared our three cognitive forcing designs to two simple explainable AI approaches and to a no-AI baseline. The results demonstrate that cognitive forcing significantly reduced overreliance compared to the simple explainable AI approaches. However, there was a trade-off: people assigned the least favorable subjective ratings to the designs that reduced the overreliance the most. To audit our work for intervention-generated inequalities, we investigated whether our interventions benefited equally people with different levels of Need for Cognition (i.e., motivation to engage in effortful mental activities). Our results show that, on average, cognitive forcing interventions benefited participants higher in Need for Cognition more. Our research suggests that human cognitive motivation moderates the effectiveness of explainable AI solutions.

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.

The application of advanced generative artificial intelligence in education is often constrained by the lack of real-time adaptability, personalization, and reliability of the content. To address these challenges, we propose ExpertAgent - an intelligent agent framework designed for personalized education that provides reliable knowledge and enables highly adaptive learning experiences. Therefore, we developed ExpertAgent, an innovative learning agent that provides users with a proactive and personalized learning experience. ExpertAgent dynamic planning of the learning content and strategy based on a continuously updated student model. Therefore, overcoming the limitations of traditional static learning content to provide optimized teaching strategies and learning experience in real time. All instructional content is grounded in a validated curriculum repository, effectively reducing hallucination risks in large language models and improving reliability and trustworthiness.

Predicting how different interventions will causally affect a specific individual is important in a variety of domains such as personalized medicine, public policy, and online marketing. There are a large number of methods to predict the effect of an existing intervention based on historical data from individuals who received it. However, in many settings it is important to predict the effects of novel interventions (e.g., a newly invented drug), which these methods do not address. Here, we consider zero-shot causal learning: predicting the personalized effects of a novel intervention. We propose CaML, a causal meta-learning framework which formulates the personalized prediction of each intervention's effect as a task. CaML trains a single meta-model across thousands of tasks, each constructed by sampling an intervention, along with its recipients and nonrecipients. By leveraging both intervention information (e.g., a drug's attributes) and individual features~(e.g., a patient's history), CaML is able to predict the personalized effects of novel interventions that do not exist at the time of training. Experimental results on real world datasets in large-scale medical claims and cell-line perturbations demonstrate the effectiveness of our approach. Most strikingly, CaML's zero-shot predictions outperform even strong baselines trained directly on data from the test interventions.

Human intelligence involves metacognitive abilities like self-regulation, recognizing limitations, and seeking assistance only when needed. While LLM Agents excel in many domains, they often lack this awareness. Overconfident agents risk catastrophic failures, while those that seek help excessively hinder efficiency. A key challenge is enabling agents with a limited intervention budget C is to decide when to request assistance. In this paper, we propose an offline framework that trains a "helper" policy to request interventions, such as more powerful models or test-time compute, by combining LLM-based process reward models (PRMs) with tabular reinforcement learning. Using state transitions collected offline, we score optimal intervention timing with PRMs and train the helper model on these labeled trajectories. This offline approach significantly reduces costly intervention calls during training. Furthermore, the integration of PRMs with tabular RL enhances robustness to off-policy data while avoiding the inefficiencies of deep RL. We empirically find that our method delivers optimal helper behavior.

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.

Rising demand for mental health support has increased interest in using Large Language Models (LLMs) for counseling. However, adapting LLMs to this high-risk safety-critical domain is hindered by the scarcity of real-world counseling data due to privacy constraints. Synthetic datasets provide a promising alternative, but existing approaches often rely on unstructured or semi-structured text inputs and overlook structural dependencies between a client's cognitive, emotional, and behavioral states, often producing psychologically inconsistent interactions and reducing data realism and quality. We introduce Graph2Counsel, a framework for generating synthetic counseling sessions grounded in Client Psychological Graphs (CPGs) that encode relationships among clients' thoughts, emotions, and behaviors. Graph2Counsel employs a structured prompting pipeline guided by counselor strategies and CPG, and explores prompting strategies including CoT (Wei et al., 2022) and Multi-Agent Feedback (Li et al., 2025a). Graph2Counsel produces 760 sessions from 76 CPGs across diverse client profiles. In expert evaluation, our dataset outperforms prior datasets on specificity, counselor competence, authenticity, conversational flow, and safety, with substantial inter-annotator agreement (Krippendorff's α = 0.70). Fine-tuning an open-source model on this dataset improves performance on CounselingBench (Nguyen et al., 2025) and CounselBench (Li et al., 2025b), showing downstream utility. We also make our code and data public.

Health misinformation disproportionately harms women, yet interventions rarely address the community norms that sustain false beliefs. We test whether culturally adaptive AI-generated video in which the presenter looks like someone from her community reduces misinformation belief among low-literacy women in suburban India. In a field experiment (N=434), participants watched an AI-generated video featuring either an adaptive or neutral presenter. The culturally adaptive presenter reduced misinformation belief by 30%, nearly twice the reduction produced by the neutral presenter compared to the non-intervention control condition. Post-experiment interviews suggest women recalled the neutral condition as a generic video but recognized the adaptive presenter. Gains persisted for three weeks. The adaptive advantage was largest for beliefs reinforced by community, such as blaming women for infertility, and negligible for medical knowledge gaps, such as understanding vaccines. These findings demonstrate the potential of culturally adaptive AI interventions to counter socially embedded health misinformation.

Knowledge augmentation has significantly enhanced the performance of Large Language Models (LLMs) in knowledge-intensive tasks. However, existing methods typically operate on the simplistic premise that model performance equates with internal knowledge, overlooking the knowledge-confidence gaps that lead to overconfident errors or uncertain truths. To bridge this gap, we propose a novel meta-cognitive framework for reliable knowledge augmentation via differentiated intervention and alignment. Our approach leverages internal cognitive signals to partition the knowledge space into mastered, confused, and missing regions, guiding targeted knowledge expansion. Furthermore, we introduce a cognitive consistency mechanism to synchronize subjective certainty with objective accuracy, ensuring calibrated knowledge boundaries. Extensive experiments demonstrate the our framework consistently outperforms strong baselines, validating its rationality in not only enhancing knowledge capabilities but also fostering cognitive behaviors that better distinguish knowns from unknowns. All codes are available at https://github.com/AI9Stars/Know-More-Know-Clearer.

Medical question answering (QA) benchmarks often focus on multiple-choice or fact-based tasks, leaving open-ended answers to real patient questions underexplored. This gap is particularly critical in mental health, where patient questions often mix symptoms, treatment concerns, and emotional needs, requiring answers that balance clinical caution with contextual sensitivity. We present CounselBench, a large-scale benchmark developed with 100 mental health professionals to evaluate and stress-test large language models (LLMs) in realistic help-seeking scenarios. The first component, CounselBench-EVAL, contains 2,000 expert evaluations of answers from GPT-4, LLaMA 3, Gemini, and online human therapists on patient questions from the public forum CounselChat. Each answer is rated across six clinically grounded dimensions, with span-level annotations and written rationales. Expert evaluations show that while LLMs achieve high scores on several dimensions, they also exhibit recurring issues, including unconstructive feedback, overgeneralization, and limited personalization or relevance. Responses were frequently flagged for safety risks, most notably unauthorized medical advice. Follow-up experiments show that LLM judges systematically overrate model responses and overlook safety concerns identified by human experts. To probe failure modes more directly, we construct CounselBench-Adv, an adversarial dataset of 120 expert-authored mental health questions designed to trigger specific model issues. Expert evaluation of 1,080 responses from nine LLMs reveals consistent, model-specific failure patterns. Together, CounselBench establishes a clinically grounded framework for benchmarking LLMs in mental health QA.

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.

Modern AI agents increasingly combine conversational interaction with autonomous task execution, such as coding and web research, raising a natural question: what happens when an agent engaged in long-horizon tasks is subjected to user persuasion? We study how belief-level intervention can influence downstream task behavior, a phenomenon we name persuasion propagation. We introduce a behavior-centered evaluation framework that distinguishes between persuasion applied during or prior to task execution. Across web research and coding tasks, we find that on-the-fly persuasion induces weak and inconsistent behavioral effects. In contrast, when the belief state is explicitly specified at task time, belief-prefilled agents conduct on average 26.9\% fewer searches and visit 16.9\% fewer unique sources than neutral-prefilled agents. These results suggest that persuasion, even in prior interaction, can affect the agent's behavior, motivating behavior-level evaluation in agentic systems.

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.

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.

Large Language Models (LLMs) exhibit strong generalization capabilities to novel tasks when prompted with language instructions and in-context demos. Since this ability sensitively depends on the quality of prompts, various methods have been explored to automate the instruction design. While these methods demonstrated promising results, they also restricted the searched prompt to one instruction. Such simplification significantly limits their capacity, as a single demo-free instruction might not be able to cover the entire complex problem space of the targeted task. To alleviate this issue, we adopt the Mixture-of-Expert paradigm and divide the problem space into a set of sub-regions; Each sub-region is governed by a specialized expert, equipped with both an instruction and a set of demos. A two-phase process is developed to construct the specialized expert for each region: (1) demo assignment: Inspired by the theoretical connection between in-context learning and kernel regression, we group demos into experts based on their semantic similarity; (2) instruction assignment: A region-based joint search of an instruction per expert complements the demos assigned to it, yielding a synergistic effect. The resulting method, codenamed Mixture-of-Prompts (MoP), achieves an average win rate of 81% against prior arts across several major benchmarks.

Interpretability research on large language models (LLMs) has yielded important insights into model behaviour, yet recurring pitfalls persist: findings that do not generalise, and causal interpretations that outrun the evidence. Our position is that causal inference specifies what constitutes a valid mapping from model activations to invariant high-level structures, the data or assumptions needed to achieve it, and the inferences it can support. Specifically, Pearl's causal hierarchy clarifies what an interpretability study can justify. Observations establish associations between model behaviour and internal components. Interventions (e.g., ablations or activation patching) support claims how these edits affect a behavioural metric (e.g., average change in token probabilities) over a set of prompts. However, counterfactual claims -- i.e., asking what the model output would have been for the same prompt under an unobserved intervention -- remain largely unverifiable without controlled supervision. We show how causal representation learning (CRL) operationalises this hierarchy, specifying which variables are recoverable from activations and under what assumptions. Together, these motivate a diagnostic framework that helps practitioners select methods and evaluations matching claims to evidence such that findings generalise.

As language models shift from single-shot answer generation toward multi-step reasoning that retrieves and consumes evidence mid-inference, evaluating the role of individual retrieved items becomes more important. Existing RAG evaluation typically targets final-answer quality, citation faithfulness, or answer-level attribution, but none of these directly targets the intervention-based, per-evidence-item utility view we study here. We introduce CUE-R, a lightweight intervention-based framework for measuring per-evidence-item operational utility in single-shot RAG using shallow observable retrieval-use traces. CUE-R perturbs individual evidence items via REMOVE, REPLACE, and DUPLICATE operators, then measures changes along three utility axes (correctness, proxy-based grounding faithfulness, and confidence error) plus a trace-divergence signal. We also outline an operational evidence-role taxonomy for interpreting intervention outcomes. Experiments on HotpotQA and 2WikiMultihopQA with Qwen-3 8B and GPT-5.2 reveal a consistent pattern: REMOVE and REPLACE substantially harm correctness and grounding while producing large trace shifts, whereas DUPLICATE is often answer-redundant yet not fully behaviorally neutral. A zero-retrieval control confirms that these effects arise from degradation of meaningful retrieval. A two-support ablation further shows that multi-hop evidence items can interact non-additively: removing both supports harms performance far more than either single removal. Our results suggest that answer-only evaluation misses important evidence effects and that intervention-based utility analysis is a practical complement for RAG evaluation.

Clinical decision-making in emergency medicine demands rapid, accurate diagnoses under uncertainty. Despite benchmark progress, evidence for LLMs as interactive aids in live physician workflows remains sparse. MedSyn lets physicians iteratively query an LLM provided with the full clinical record while initially viewing only the chief complaint. Seven physicians (three seniors, four residents) completed baseline and AI-assisted sessions across 52 MIMIC-IV cases stratified by difficulty. Blinded evaluation showed residents' Hard-case correctness rose from 0.589 to 0.734; difficulty-standardised completely-correct rates confirmed a medium effect (Δ = 0.092; p = 0.071; d = 0.47). Automated metrics corroborated these gains: standardised any-match accuracy improved by 0.156 (p < 0.0001), and residents showed the largest F1 gain (Δ = 0.138; p < 0.0001). Dialogue analysis revealed expertise-dependent strategies (seniors asked targeted, hypothesis-driven questions; residents relied on broader queries) and cross-expertise concordance increased (Δ = 0.145; p < 0.0001). Interactive LLM support meaningfully enhances diagnostic reasoning.

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

Training data attribution (TDA) aims to identify training examples that shape model behavior, but its intervention value depends on both which examples are selected and how they are modified. Influence functions (IF) estimate behavioral changes under infinitesimal reweighting, yet IF-selected examples often show limited advantages over random selection under conventional weight-based interventions. This raises the question of whether influential examples lack intervention value or whether reweighting fails to realize their behavioral leverage.We introduce influence-guided response rewriting, which uses IF to identify intervention targets and replaces their responses with behavior-aligned or behavior-opposed supervision while keeping instructions fixed. Across four open-weight LLMs, we compare rewriting and reweighting on the same influence-selected examples using epistemic abstention as our primary testbed. Response rewriting produces stronger, more persistent, and bidirectional behavioral shifts, while reweighting the same examples yields weak and inconsistent effects. Further analyses show that influence-selected examples provide greater rewriting leverage than alternative selectors, with changes remaining concentrated on target-relevant behaviors. The same qualitative contrast extends to safety refusal. These results distinguish the local reweighting effects captured by influence estimates from the broader intervention leverage of the examples they identify, motivating intervention-aware evaluation of TDA methods.

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.

Mechanistic interpretability seeks to understand the internal mechanisms of machine learning models, where localization -- identifying the important model components -- is a key step. Activation patching, also known as causal tracing or interchange intervention, is a standard technique for this task (Vig et al., 2020), but the literature contains many variants with little consensus on the choice of hyperparameters or methodology. In this work, we systematically examine the impact of methodological details in activation patching, including evaluation metrics and corruption methods. In several settings of localization and circuit discovery in language models, we find that varying these hyperparameters could lead to disparate interpretability results. Backed by empirical observations, we give conceptual arguments for why certain metrics or methods may be preferred. Finally, we provide recommendations for the best practices of activation patching going forwards.

We propose an algorithm for change point monitoring in linear causal models that accounts for interventions. Through a special centralization technique, we can concentrate the changes arising from causal propagation across nodes into a single dimension. Additionally, by selecting appropriate intervention nodes based on Kullback-Leibler divergence, we can amplify the change magnitude. We also present an algorithm for selecting the intervention values, which aids in the identification of the most effective intervention nodes. Two monitoring methods are proposed, each with an adaptive intervention policy to make a balance between exploration and exploitation. We theoretically demonstrate the first-order optimality of the proposed methods and validate their properties using simulation datasets and two real-world case studies.

Large language models are increasingly used for mental health support, yet their conversational coherence alone does not ensure clinical appropriateness. Existing general-purpose safeguards often fail to distinguish between therapeutic disclosures and genuine clinical crises, leading to safety failures. To address this gap, we introduce a clinically grounded risk taxonomy, developed in collaboration with PhD-level psychologists, that identifies actionable harm (e.g., self-harm and harm to others) while preserving space for safe, non-crisis therapeutic content. We release MindGuard-testset, a dataset of real-world multi-turn conversations annotated at the turn level by clinical experts. Using synthetic dialogues generated via a controlled two-agent setup, we train MindGuard, a family of lightweight safety classifiers (with 4B and 8B parameters). Our classifiers reduce false positives at high-recall operating points and, when paired with clinician language models, help achieve lower attack success and harmful engagement rates in adversarial multi-turn interactions compared to general-purpose safeguards. We release all models and human evaluation data.

In large organisations, identifying experts on a given topic is crucial in leveraging the internal knowledge spread across teams and departments. So-called enterprise expert retrieval systems automatically discover and structure employees' expertise based on the vast amount of heterogeneous data available about them and the work they perform. Evaluating these systems requires comprehensive ground truth expert annotations, which are hard to obtain. Therefore, the annotation process typically relies on automated recommendations of knowledge areas to validate. This case study provides an analysis of how these recommendations can impact the evaluation of expert finding systems. We demonstrate on a popular benchmark that system-validated annotations lead to overestimated performance of traditional term-based retrieval models and even invalidate comparisons with more recent neural methods. We also augment knowledge areas with synonyms to uncover a strong bias towards literal mentions of their constituent words. Finally, we propose constraints to the annotation process to prevent these biased evaluations, and show that this still allows annotation suggestions of high utility. These findings should inform benchmark creation or selection for expert finding, to guarantee meaningful comparison of methods.

Emotional support dialogue systems aim to reduce help-seekers' distress and help them overcome challenges. While human valuesx2013core beliefs that shape an individual's prioritiesx2013are increasingly emphasized in contemporary psychological therapy for their role in fostering internal transformation and long-term emotional well-being, their integration into emotional support systems remains underexplored. To bridge this gap, we present a value-driven method for training emotional support dialogue systems designed to reinforce positive values in seekers. Notably, our model identifies which values to reinforce at each turn and how to do so, by leveraging online support conversations from Reddit. We evaluate the method across support skills, seekers' emotional intensity, and value reinforcement. Our method consistently outperforms various baselines, effectively exploring and eliciting values from seekers. Additionally, leveraging crowd knowledge from Reddit significantly enhances its effectiveness. Therapists highlighted its ability to validate seekers' challenges and emphasize positive aspects of their situationsx2013both crucial elements of value reinforcement. Our work, being the first to integrate value reinforcement into emotional support systems, demonstrates its promise and establishes a foundation for future research.

Patient world models are increasingly proposed as simulators of clinical trials, and recent surveys rank their capabilities on a ladder from temporal prediction to counterfactual rollouts. Position on that ladder is currently assigned by reading papers rather than by measurement. We turn the counterfactual rung into a measured quantity. From 30,119 completed phase 2/3 trials with results posted to ClinicalTrials.gov we construct 9,996 audited within-trial contrasts from 7,207 trials, and we score a simulator on how much of its accuracy depends on knowing which intervention was tested. The instrument is an intervention-blind reference: the same model, trained on the same trials, with every intervention-identifying field withheld. Interventional skill is the error the full model removes relative to that reference. On a temporal split (878 test contrasts from 655 trials) a registry-trained gradient-boosting simulator removes a fifth of the error of a trivial baseline, but its interventional skill is -0.12 (95% CI -0.21 to -0.05): withholding the intervention makes it better, and no alternative featurisation, stratum, temporal cut or same-molecule retrieval yields an interval above zero. A frontier language model reading only the registered protocol has interventional skill 0.20 [0.08, 0.31]; smaller and open-weight models sit at the limit of detection. Perturbation tests show the large model uses the intervention as such: swapping the arms reverses the sign of its prediction in 86% of contrasts. The blind reference is itself not drug-blind (a language model recovers the withheld drug class 45% of the time from the blind prompt), so interventional skill is a conservative lower bound. A reliability layer shows that ranking by predicted error lowers it but that calibrated error control does not transfer under temporal shift. Benchmark, code, prompts and per-call model outputs are released.

Unlike empathetic dialogues, the system in emotional support conversations (ESC) is expected to not only convey empathy for comforting the help-seeker, but also proactively assist in exploring and addressing their problems during the conversation. In this work, we study the problem of mixed-initiative ESC where the user and system can both take the initiative in leading the conversation. Specifically, we conduct a novel analysis on mixed-initiative ESC systems with a tailor-designed schema that divides utterances into different types with speaker roles and initiative types. Four emotional support metrics are proposed to evaluate the mixed-initiative interactions. The analysis reveals the necessity and challenges of building mixed-initiative ESC systems. In the light of this, we propose a knowledge-enhanced mixed-initiative framework (KEMI) for ESC, which retrieves actual case knowledge from a large-scale mental health knowledge graph for generating mixed-initiative responses. Experimental results on two ESC datasets show the superiority of KEMI in both content-preserving evaluation and mixed initiative related analyses.

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.

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.

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.

Skills are external artifacts that Large Language Models (LLMs) consume at inference time to improve their performance on specialized domains by incorporating relevant procedural and domain knowledge. Expert-authored skills are expensive to produce, and the resulting artifacts are not optimized for the specific model that consumes them, whose failure modes can vary with version, scale and training. In addition, emerging tasks may fall outside the scope of existing skill libraries, creating a need to develop new skills before curated training data become available. Recent works have explored automated skill optimization through reflection, but they require a curated, in-distribution training set, which users might not always have. To address these limitations, we present Prompt2Skill, a framework that builds skills from natural-language task description alone. From the prompt, the system derives a task specification, discovers or synthesizes datasets, and refines the skill in a closed loop of reflective editing. Across four domains spanning question answering, reading comprehension, spreadsheet manipulation, and mathematical reasoning, Prompt2Skill consistently outperforms the direct prompting baseline, achieving an average improvement of 10.8 across open-source and frontier models.

Psychotherapists need repeated training and supervision by experts; however, scalability is problematic. Here we present MyMentorLLM, a multimodal voice- and text-based simulation environment for deliberate practice, used to generate 2,100 complete Cognitive Behavioural Therapy (CBT) training sessions. Each session links a DSM-5-TR-grounded patient (with major depressive, generalised anxiety or borderline personality disorder), a therapist-in-training and an expert supervisor. As an initial implementation, we adopted CBT because its structured procedures and competency-based supervision facilitate standardised simulation and evaluation. Sessions were analysed for emotional dynamics, therapeutic competence and diagnostic accuracy. Simulated patients expressed disorder-congruent emotional profiles, which trainee therapists mirrored as in real human counselling. The quality of supervision differed across LLMs: while most models overestimated trainees' competences, native speech-to-speech was closest to human scores. Supervisors' feedback led to better diagnoses in simulated psychotherapists in 5 out of 7 LLMs, and symptom identification accuracy increased with model size. This work shows that simulation of deliberate practice is possible for CBT training, although patient fidelity, calibration of supervisors, and harmful feedback should be evaluated together.

The technique of data augmentation (DA) is often used in machine learning for regularization purposes to better generalize under i.i.d. settings. In this work, we present a unifying framework with topics in causal inference to make a case for the use of DA beyond just the i.i.d. setting, but for generalization across interventions as well. Specifically, we argue that when the outcome generating mechanism is invariant to our choice of DA, then such augmentations can effectively be thought of as interventions on the treatment generating mechanism itself. This can potentially help to reduce bias in causal effect estimation arising from hidden confounders. In the presence of such unobserved confounding we typically make use of instrumental variables (IVs) -- sources of treatment randomization that are conditionally independent of the outcome. However, IVs may not be as readily available as DA for many applications, which is the main motivation behind this work. By appropriately regularizing IV based estimators, we introduce the concept of IV-like (IVL) regression for mitigating confounding bias and improving predictive performance across interventions even when certain IV properties are relaxed. Finally, we cast parameterized DA as an IVL regression problem and show that when used in composition can simulate a worst-case application of such DA, further improving performance on causal estimation and generalization tasks beyond what simple DA may offer. This is shown both theoretically for the population case and via simulation experiments for the finite sample case using a simple linear example. We also present real data experiments to support our case.

Specialist epilepsy expertise is scarce in resource-constrained settings, making LLM-based decision support attractive for frontline clinicians managing longitudinal treatment. Such systems must adapt to local prescribing practice and know when to defer. We study this problem in Ugandan pediatric epilepsy care, predicting anti-seizure medication regimens from longitudinal unstructured clinic notes. Standard prompting achieves non-trivial agreement with physician prescriptions, but neurologist review shows that many errors reflect distribution-miscalibrated prescribing defaults rather than failures to parse the local record. We introduce MANANA, a non-parametric prompt-learning framework that learns local prescribing guidance from a small patient-level training set. MANANA converts observed prescription errors into auditable prompt memories, instantiated in single-agent and multi-agent variants, and improves over classical ML models, direct LLM prompting, and prompt-optimization baselines across two independently collected Ugandan cohorts. We further propose Bayesian prompt averaging, which converts the learned prompt trajectory into prescription likelihoods and an uncertainty-based deferral signal. On the independently collected held-out cohort, this improves visit-level top-3 prescription accuracy by 4-8 percentage points over prompt-optimization baselines and enables selective prediction: the system can auto-handle the most confident half of cases at 95% precision, or the most confident quarter at 99% precision, while deferring lower-confidence cases for specialist review.

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.

Although language models are trained to mimic humans, the resulting systems display capabilities beyond the scope of any one person. To understand this phenomenon, we use a controlled setting to identify properties of the training data that lead a model to transcend the performance of its data sources. We build on previous work to outline three modes of transcendence, which we call skill denoising, skill selection, and skill generalization. We then introduce a knowledge graph-based setting in which simulated experts generate data based on their individual expertise. We highlight several aspects of data diversity that help to enable the model's transcendent capabilities. Additionally, our data generation setting offers a controlled testbed that we hope is valuable for future research in the area.

Multi-expert systems, where multiple Large Language Models (LLMs) collaborate to solve complex tasks, are increasingly adopted for high-performance reasoning and generation. However, the orchestration policies governing expert interaction and sequencing remain largely opaque. We introduce INFORM, an interpretability analysis that treats orchestration as an explicit, analyzable computation, enabling the decoupling of expert interaction structure, execution order, and functional attribution. We use INFORM to evaluate an orchestrator on GSM8K, HumanEval, and MMLU using a homogeneous consortium of ten instruction-tuned experts drawn from LLaMA-3.1 8B, Qwen3 8B, and DeepSeek-R1 8B, with controlled decoding-temperature variation, and a secondary heterogeneous consortium spanning 1B-7B parameter models. Across tasks, routing dominance is a poor proxy for functional necessity. We reveal a divergence between relational importance, captured by routing mass and interaction topology, and intrinsic importance, measured via gradient sensitivity: frequently selected experts often act as interaction hubs with limited influence, while sparsely routed experts can be structurally critical. Orchestration behaviors emerge asynchronously, with expert centralization preceding stable routing confidence and expert ordering remaining non-deterministic. Targeted ablations show that masking intrinsically important experts induces disproportionate collapse in interaction structure compared to masking frequent peers, confirming that INFORM exposes functional and structural dependencies beyond accuracy metrics alone. Our code is available at https://github.com/parmanu-lcs2/inform.

We present the Mixture-of-Tunable-Experts (MoTE), a method that extends the Mixture-of-Experts architecture of Large Language Models (LLMs). Without additional training, MoTE enables meaningful and focused behavior changes in LLMs on-the-fly during inference time. By analyzing the digital LLM brain of DeepSeek-R1 using a technique we dub 'functional Token Resonance Imaging' (fTRI) -- inspired by fMRI and using prompts designed to elicit specific behavior (e.g., 'What happened {time}{place}?') -- we empirically identify distinctive experts associated with behaviors like refusal responses. Using MoTE we are able to intervene and control such specific behavior. We switched off the top 10 most refusal-relevant experts (0.07% of R1's 14,848 routed experts), achieving a 52% refusal reduction on sensitive reference prompts without performance degradation on MT-Bench. Random expert deactivation resulted in smaller behavioral shifts with increased noise, whereas forced expert activation led to significantly higher refusal rates. Our approach shares similarities with sparse autoencoders (SAEs) in terms of explainability and steerability. Unlike SAEs, MoTE does not require large training efforts, as within MoEs with a vast number of experts, specialization already emerged naturally during pretraining. Our findings suggest that significant functional mechanisms in Mixture-of-Experts architectures can at least partially be localized in a small number of specific experts, rather than being distributed throughout the model's weights. Expert subgroups can be tuned to trigger significant behavior variations, providing insights into the inner workings of LLMs.

Mixture-of-Experts (MoE) architectures within Large Reasoning Models (LRMs) have achieved impressive reasoning capabilities by selectively activating experts to facilitate structured cognitive processes. Despite notable advances, existing reasoning models often suffer from cognitive inefficiencies like overthinking and underthinking. To address these limitations, we introduce a novel inference-time steering methodology called Reinforcing Cognitive Experts (RICE), designed to improve reasoning performance without additional training or complex heuristics. Leveraging normalized Pointwise Mutual Information (nPMI), we systematically identify specialized experts, termed ''cognitive experts'' that orchestrate meta-level reasoning operations characterized by tokens like ''<think>''. Empirical evaluations with leading MoE-based LRMs (DeepSeek-R1 and Qwen3-235B) on rigorous quantitative and scientific reasoning benchmarks demonstrate noticeable and consistent improvements in reasoning accuracy, cognitive efficiency, and cross-domain generalization. Crucially, our lightweight approach substantially outperforms prevalent reasoning-steering techniques, such as prompt design and decoding constraints, while preserving the model's general instruction-following skills. These results highlight reinforcing cognitive experts as a promising, practical, and interpretable direction to enhance cognitive efficiency within advanced reasoning models.

In machine learning systems, bias mitigation approaches aim to make outcomes fairer across privileged and unprivileged groups. Bias mitigation methods work in different ways and have known "waterfall" effects, e.g., mitigating bias at one place may manifest bias elsewhere. In this paper, we aim to characterise impacted cohorts when mitigation interventions are applied. To do so, we treat intervention effects as a classification task and learn an explainable meta-classifier to identify cohorts that have altered outcomes. We examine a range of bias mitigation strategies that work at various stages of the model life cycle. We empirically demonstrate that our meta-classifier is able to uncover impacted cohorts. Further, we show that all tested mitigation strategies negatively impact a non-trivial fraction of cases, i.e., people who receive unfavourable outcomes solely on account of mitigation efforts. This is despite improvement in fairness metrics. We use these results as a basis to argue for more careful audits of static mitigation interventions that go beyond aggregate metrics.

Synthesizing clinical evidence largely relies on systematic reviews of clinical trials and retrospective analyses from medical literature. However, the rapid expansion of publications presents challenges in efficiently identifying, summarizing, and updating clinical evidence. Here, we introduce TrialMind, a generative artificial intelligence (AI) pipeline for facilitating human-AI collaboration in three crucial tasks for evidence synthesis: study search, screening, and data extraction. To assess its performance, we chose published systematic reviews to build the benchmark dataset, named TrialReviewBench, which contains 100 systematic reviews and the associated 2,220 clinical studies. Our results show that TrialMind excels across all three tasks. In study search, it generates diverse and comprehensive search queries to achieve high recall rates (Ours 0.711-0.834 v.s. Human baseline 0.138-0.232). For study screening, TrialMind surpasses traditional embedding-based methods by 30% to 160%. In data extraction, it outperforms a GPT-4 baseline by 29.6% to 61.5%. We further conducted user studies to confirm its practical utility. Compared to manual efforts, human-AI collaboration using TrialMind yielded a 71.4% recall lift and 44.2% time savings in study screening and a 23.5% accuracy lift and 63.4% time savings in data extraction. Additionally, when comparing synthesized clinical evidence presented in forest plots, medical experts favored TrialMind's outputs over GPT-4's outputs in 62.5% to 100% of cases. These findings show the promise of LLM-based approaches like TrialMind to accelerate clinical evidence synthesis via streamlining study search, screening, and data extraction from medical literature, with exceptional performance improvement when working with human experts.

Fluent guidance is not the same as useful intervention. LLM tutors are typically trained to generate the next teacher utterance, implicitly assuming that every student turn warrants a response. However, our experiments indicate that this conflates tutoring capability (what to say) with intervention necessity (whether to say it). We introduce DICE, a framework that decouples intervention decisions from response generation by first selecting an explicit pedagogical action. To calibrate this action selection policy, we define Intervention Value (IV), a rollout-grounded counterfactual metric that compares each action against non-intervention. IV shows that many prescribed interventions provide little or no marginal benefit. We further introduce DICE-Bench, a multi-variant math tutoring benchmark with skill-preserving problem variants for session-level evaluation. Using IV-weighted and KL-regularized policy optimization, DICE learns to intervene selectively while preserving tutoring effectiveness. In simulated tutoring sessions, DICE reduces the over-intervention rate to near zero while guiding students to correct solutions in approximately 3-4 fewer turns on average than existing Socratic tutoring baselines.

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

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.

The answering quality of an aligned large language model (LLM) can be drastically improved if treated with proper crafting of prompts. In this paper, we propose ExpertPrompting to elicit the potential of LLMs to answer as distinguished experts. We first utilize In-Context Learning to automatically synthesize detailed and customized descriptions of the expert identity for each specific instruction, and then ask LLMs to provide answer conditioned on such agent background. Based on this augmented prompting strategy, we produce a new set of instruction-following data using GPT-3.5, and train a competitive open-source chat assistant called ExpertLLaMA. We employ GPT4-based evaluation to show that 1) the expert data is of significantly higher quality than vanilla answers, and 2) ExpertLLaMA outperforms existing open-source opponents and achieves 96\% of the original ChatGPT's capability. All data and the ExpertLLaMA model will be made publicly available at https://github.com/OFA-Sys/ExpertLLaMA.

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.

In response to the pressing need for advanced clinical problem-solving tools in healthcare, we introduce BooksMed, a novel framework based on a Large Language Model (LLM). BooksMed uniquely emulates human cognitive processes to deliver evidence-based and reliable responses, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to effectively quantify evidence strength. For clinical decision-making to be appropriately assessed, an evaluation metric that is clinically aligned and validated is required. As a solution, we present ExpertMedQA, a multispecialty clinical benchmark comprised of open-ended, expert-level clinical questions, and validated by a diverse group of medical professionals. By demanding an in-depth understanding and critical appraisal of up-to-date clinical literature, ExpertMedQA rigorously evaluates LLM performance. BooksMed outperforms existing state-of-the-art models Med-PaLM 2, Almanac, and ChatGPT in a variety of medical scenarios. Therefore, a framework that mimics human cognitive stages could be a useful tool for providing reliable and evidence-based responses to clinical inquiries.

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.

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

Large language models offer broad capabilities, but adapting them to evolving domains, tools, and requirements often entails repeated post-training. Autonomous systems automate parts of this process by proposing updates, training candidates, and using evaluation feedback to select subsequent proposals. As evidence accumulates, a central problem emerges: which past update evidence remains actionable after subsequent training has changed the parent model? An update's effect depends on its parent, data, and training stage. Treating past success as context-free permission can waste compute. If the resulting child is promoted, it can also degrade the subsequent training trajectory. We formulate this problem as conditional experience transfer and introduce Boundary-Calibrated Intervention Transfer (BCIT), a method that authorizes experience reuse before weight-changing training. BCIT binds an observed effect to its source context, checks applicability conditions, vetoes candidates with named hard conflicts, and obtains current-state evidence through a bounded training trial when needed. Fully trained candidates still face a shared adoption rule, and only observed events extend memory. On one 4B model adapted across finance reasoning, text-to-SQL, and function calling, candidate updates exhibit heterogeneous target and retention effects across the evaluated contexts. Under matched candidates, evidence, and compute, BCIT authorizes fewer harmful updates and attains higher equal-budget final-model quality than the evaluated alternatives. These results support treating experience authorization as a distinct problem in autonomous post-training.

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

Mixture-of-Experts (MoE) models mostly use a router to assign tokens to specific expert modules, activating only partial parameters and often outperforming dense models. We argue that the separation between the router's decision-making and the experts' execution is a critical yet overlooked issue, leading to suboptimal expert selection and ineffective learning. To address this, we propose Autonomy-of-Experts (AoE), a novel MoE paradigm in which experts autonomously select themselves to process inputs. AoE is based on the insight that an expert is aware of its own capacity to effectively process a token, an awareness reflected in the scale of its internal activations. In AoE, routers are removed; instead, experts pre-compute internal activations for inputs and are ranked based on their activation norms. Only the top-ranking experts proceed with the forward pass, while the others abort. The overhead of pre-computing activations is reduced through a low-rank weight factorization. This self-evaluating-then-partner-comparing approach ensures improved expert selection and effective learning. We pre-train language models having 700M up to 4B parameters, demonstrating that AoE outperforms traditional MoE models with comparable efficiency.

Proactive interventions by LLM critic models are often assumed to improve reliability, yet their effects at deployment time are poorly understood. We show that a binary LLM critic with strong offline accuracy (AUROC 0.94) can nevertheless cause severe performance degradation, inducing a 26 percentage point (pp) collapse on one model while affecting another by near zero pp. This variability demonstrates that LLM critic accuracy alone is insufficient to determine whether intervention is safe. We identify a disruption-recovery tradeoff: interventions may recover failing trajectories but also disrupt trajectories that would have succeeded. Based on this insight, we propose a pre-deployment test that uses a small pilot of 50 tasks to estimate whether intervention is likely to help or harm, without requiring full deployment. Across benchmarks, the test correctly anticipates outcomes: intervention degrades performance on high-success tasks (0 to -26 pp), while yielding a modest improvement on the high-failure ALFWorld benchmark (+2.8 pp, p=0.014). The primary value of our framework is therefore identifying when not to intervene, preventing severe regressions before deployment.

Mixture of Experts (MoE) offers remarkable performance and computational efficiency by selectively activating subsets of model parameters. Traditionally, MoE models use homogeneous experts, each with identical capacity. However, varying complexity in input data necessitates experts with diverse capabilities, while homogeneous MoE hinders effective expert specialization and efficient parameter utilization. In this study, we propose a novel Heterogeneous Mixture of Experts (HMoE), where experts differ in size and thus possess diverse capacities. This heterogeneity allows for more specialized experts to handle varying token complexities more effectively. To address the imbalance in expert activation, we propose a novel training objective that encourages the frequent activation of smaller experts, enhancing computational efficiency and parameter utilization. Extensive experiments demonstrate that HMoE achieves lower loss with fewer activated parameters and outperforms conventional homogeneous MoE models on various pre-training evaluation benchmarks. Codes will be released upon acceptance.

When assisting human users in reinforcement learning (RL), we can represent users as RL agents and study key parameters, called user traits, to inform intervention design. We study the relationship between user behaviors (policy classes) and user traits. Given an environment, we introduce an intuitive tool for studying the breakdown of "user types": broad sets of traits that result in the same behavior. We show that seemingly different real-world environments admit the same set of user types and formalize this observation as an equivalence relation defined on environments. By transferring intervention design between environments within the same equivalence class, we can help rapidly personalize interventions.

Highly effective, task-specific prompts are often heavily engineered by experts to integrate detailed instructions and domain insights based on a deep understanding of both instincts of large language models (LLMs) and the intricacies of the target task. However, automating the generation of such expert-level prompts remains elusive. Existing prompt optimization methods tend to overlook the depth of domain knowledge and struggle to efficiently explore the vast space of expert-level prompts. Addressing this, we present PromptAgent, an optimization method that autonomously crafts prompts equivalent in quality to those handcrafted by experts. At its core, PromptAgent views prompt optimization as a strategic planning problem and employs a principled planning algorithm, rooted in Monte Carlo tree search, to strategically navigate the expert-level prompt space. Inspired by human-like trial-and-error exploration, PromptAgent induces precise expert-level insights and in-depth instructions by reflecting on model errors and generating constructive error feedback. Such a novel framework allows the agent to iteratively examine intermediate prompts (states), refine them based on error feedbacks (actions), simulate future rewards, and search for high-reward paths leading to expert prompts. We apply PromptAgent to 12 tasks spanning three practical domains: BIG-Bench Hard (BBH), as well as domain-specific and general NLP tasks, showing it significantly outperforms strong Chain-of-Thought and recent prompt optimization baselines. Extensive analyses emphasize its capability to craft expert-level, detailed, and domain-insightful prompts with great efficiency and generalizability.

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.

Multimodal Mixture-of-Experts (MoE) models have achieved remarkable performance on vision-language tasks. However, we identify a puzzling phenomenon termed Seeing but Not Thinking: models accurately perceive image content yet fail in subsequent reasoning, while correctly solving identical problems presented as pure text. Through systematic analysis, we first verify that cross-modal semantic sharing exists in MoE architectures, ruling out semantic alignment failure as the sole explanation. We then reveal that visual experts and domain experts exhibit layer-wise separation, with image inputs inducing significant routing divergence from text inputs in middle layers where domain experts concentrate. Based on these findings, we propose the Routing Distraction hypothesis: when processing visual inputs, the routing mechanism fails to adequately activate task-relevant reasoning experts. To validate this hypothesis, we design a routing-guided intervention method that enhances domain expert activation. Experiments on three multimodal MoE models across six benchmarks demonstrate consistent improvements, with gains of up to 3.17% on complex visual reasoning tasks. Our analysis further reveals that domain expert identification locates cognitive functions rather than sample-specific solutions, enabling effective transfer across tasks with different information structures.

Planning effective interventions in biological systems requires treatment-effect models that adapt to unseen biological contexts by identifying their specific underlying mechanisms. Yet single-cell perturbation datasets span only a handful of biological contexts, and existing methods cannot leverage new interventional evidence at inference time to adapt beyond their training data. To meta-learn a perturbation effect estimator, we present MapPFN, a prior-data fitted network (PFN) pretrained on synthetic data generated from a prior over causal perturbations. Given a set of experiments, MapPFN uses in-context learning to predict post-perturbation distributions, without gradient-based optimization. Despite being pretrained on in silico gene knockouts alone, MapPFN identifies differentially expressed genes, matching the performance of models trained on real single-cell data. Our code and data are available at https://github.com/marvinsxtr/MapPFN.

Retrieval-augmented QA pipelines often route retrieved passages through an LLM rewriter before a smaller reader, lifting F1 by tens of points on multi-hop benchmarks; this gain is typically credited to improved evidence quality. We ask whether that lift is causally driven by the gold answer string appearing in the rewritten context rather than by curation per se, using a controlled intervention audit. For each rewritten context we re-run the reader after one of four controlled edits to the compile output: removing the gold answer span, replacing a length-matched random non-answer span (placebo), or injecting the gold into rewrites where it was absent (at the prefix or at a midpoint sentence boundary). Across twelve completed (cell, baseline) intervention runs spanning three reader families (Qwen2.5-7B, Qwen3.5-35B, GLM-4.7), two datasets (HotpotQA, 2WikiMultihopQA), and three compiler arrangements (MA-only, MB-only, MA+verify), removing the gold answer drops reader F1 by 28 to 64 points beyond the length-matched placebo on paired answer-in-compile strata, and prepending the gold into rewrites that lacked it raises F1 by +0.7 to +9.7 points in 10 of 12 (cell, baseline) combinations. A companion five-sentinel audit shows the conventional single-[MASK] probe is itself sentinel-fragile: on 2Wiki it reports a +4.12~F1 ``non-leakage residual'' that flips to -3.33 to -7.81~F1 under four alternative sentinels and fails an equivalence test for three of those four (1/4~pass). We do not propose a new rewriter or mitigation; we release the intervention runner and the sentinel panel so that other rewriter-gain claims can be tested against the same standard.

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.

The Interactive Knowledge Assistant Track (iKAT) 2024 focuses on advancing conversational assistants, able to adapt their interaction and responses from personalized user knowledge. The track incorporates a Personal Textual Knowledge Base (PTKB) alongside Conversational AI tasks, such as passage ranking and response generation. Query Rewrite being an effective approach for resolving conversational context, we explore Large Language Models (LLMs), as query rewriters. Specifically, our submitted runs explore multi-aspect query generation using the MQ4CS framework, which we further enhance with Learned Sparse Retrieval via the SPLADE architecture, coupled with robust cross-encoder models. We also propose an alternative to the previous interleaving strategy, aggregating multiple aspects during the reranking phase. Our findings indicate that multi-aspect query generation is effective in enhancing performance when integrated with advanced retrieval and reranking models. Our results also lead the way for better personalization in Conversational Search, relying on LLMs to integrate personalization within query rewrite, and outperforming human rewrite performance.

This study explores the use of Large language models to analyze therapist remarks in a psychotherapeutic setting. The paper focuses on the application of BERTopic, a machine learning-based topic modeling tool, to the dialogue of two different groups of therapists (classical and modern), which makes it possible to identify and describe a set of topics that consistently emerge across these groups. The paper describes in detail the chosen algorithm for BERTopic, which included creating a vector space from a corpus of therapist remarks, reducing its dimensionality, clustering the space, and creating and optimizing topic representation. Along with the automatic topical modeling by the BERTopic, the research involved an expert assessment of the findings and manual topic structure optimization. The topic modeling results highlighted the most common and stable topics in therapists speech, offering insights into how language patterns in therapy develop and remain stable across different therapeutic styles. This work contributes to the growing field of machine learning in psychotherapy by demonstrating the potential of automated methods to improve both the practice and training of therapists. The study highlights the value of topic modeling as a tool for gaining a deeper understanding of therapeutic dialogue and offers new opportunities for improving therapeutic effectiveness and clinical supervision.

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.

Large language models (LLMs) have shown strong performance on isolated psychiatric tasks, including dialogue, diagnosis, and treatment planning, yet existing benchmarks rarely simulate complete psychiatric clinical encounters. We introduce MentalHospital, a virtual evaluation environment for LLM-based psychiatric clinical encounters. MentalHospital instantiates the Subjective Interviewing, Objective Examination, Diagnostic Assessment, and Treatment Planning (S.O.A.P.) workflow, using skill-augmented standardized patients constructed from 1,193 de-identified psychiatric electronic health record (EHR) cases spanning all major ICD-11 categories and 76 disorders. Each encounter is assessed through a dual-track protocol that combines objective comparison against EHR-derived references with subjective assessment of clinical process quality. To scale specialist judgment, we develop MentalEval, five domain-specific evaluators covering communication empathy, interviewing professionalism, clinical-note quality, diagnostic rigor, and treatment appropriateness, trained with rubric-grounded SFT and expert-guided DPO. Survey responses from 22 clinicians support MentalHospital's clinical fidelity (3.88/5), while MentalEval achieves strong expert alignment with an average QWK of 0.944. Benchmarking shows that even the strongest LLM trails clinicians by 37.28 percentage points in objective psychiatric competence, with mental status assessment as a key bottleneck.

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

Large Language Models (LLMs), with their flexible generation abilities, can be powerful data sources in domains with few or no available corpora. However, problems like hallucinations and biases limit such applications. In this case study, we pick nutrition counselling, a domain lacking any public resource, and show that high-quality datasets can be gathered by combining LLMs, crowd-workers and nutrition experts. We first crowd-source and cluster a novel dataset of diet-related issues, then work with experts to prompt ChatGPT into producing related supportive text. Finally, we let the experts evaluate the safety of the generated text. We release HAI-coaching, the first expert-annotated nutrition counselling dataset containing ~2.4K dietary struggles from crowd workers, and ~97K related supportive texts generated by ChatGPT. Extensive analysis shows that ChatGPT while producing highly fluent and human-like text, also manifests harmful behaviours, especially in sensitive topics like mental health, making it unsuitable for unsupervised use.

The National Comprehensive Cancer Network (NCCN) provides evidence-based guidelines for cancer treatment. Translating complex patient presentations into guideline-compliant treatment recommendations is time-intensive, requires specialized expertise, and is prone to error. Advances in large language model (LLM) capabilities promise to reduce the time required to generate treatment recommendations and improve accuracy. We present an LLM agent-based approach to automatically generate guideline-concordant treatment trajectories for patients with non-small cell lung cancer (NSCLC). Our contributions are threefold. First, we construct a novel longitudinal dataset of 121 cases of NSCLC patients that includes clinical encounters, diagnostic results, and medical histories, each expertly annotated with the corresponding NCCN guideline trajectories by board-certified oncologists. Second, we demonstrate that existing LLMs possess domain-specific knowledge that enables high-quality proxy benchmark generation for both model development and evaluation, achieving strong correlation (Spearman coefficient r=0.88, RMSE = 0.08) with expert-annotated benchmarks. Third, we develop a hybrid approach combining expensive human annotations with model consistency information to create both the agent framework that predicts the relevant guidelines for a patient, as well as a meta-classifier that verifies prediction accuracy with calibrated confidence scores for treatment recommendations (AUROC=0.800), a critical capability for communicating the accuracy of outputs, custom-tailoring tradeoffs in performance, and supporting regulatory compliance. This work establishes a framework for clinically viable LLM-based guideline adherence systems that balance accuracy, interpretability, and regulatory requirements while reducing annotation costs, providing a scalable pathway toward automated clinical decision support.

Large visual language models (VLMs) have shown strong multi-modal medical reasoning ability, but most operate as end-to-end black boxes, diverging from clinicians' evidence-based, staged workflows and hindering clinical accountability. Complementarily, expert visual grounding models can accurately localize regions of interest (ROIs), providing explicit, reliable evidence that improves both reasoning accuracy and trust. In this paper, we introduce CARE, advancing Clinical Accountability in multi-modal medical Reasoning with an Evidence-grounded agentic framework. Unlike existing approaches that couple grounding and reasoning within a single generalist model, CARE decomposes the task into coordinated sub-modules to reduce shortcut learning and hallucination: a compact VLM proposes relevant medical entities; an expert entity-referring segmentation model produces pixel-level ROI evidence; and a grounded VLM reasons over the full image augmented by ROI hints. The VLMs are optimized with reinforcement learning with verifiable rewards to align answers with supporting evidence. Furthermore, a VLM coordinator plans tool invocation and reviews evidence-answer consistency, providing agentic control and final verification. Evaluated on standard medical VQA benchmarks, our CARE-Flow (coordinator-free) improves average accuracy by 10.9% over the same size (10B) state-of-the-art (SOTA). With dynamic planning and answer review, our CARE-Coord yields a further gain, outperforming the heavily pre-trained SOTA by 5.2%. Our experiments demonstrate that an agentic framework that emulates clinical workflows, incorporating decoupled specialized models and explicit evidence, yields more accurate and accountable medical AI. Project page: https://xypb.github.io/CARE-Project-Page/

Skills are a natural unit for describing what a language model can do and how its behavior can be changed. However, existing characterizations rely on human-written taxonomies, textual descriptions, or manual profiling pipelines--all external hypotheses about what matters that need not align with the model's internal representations. We argue that when the goal is to intervene on model behavior, skill characterization should be *model-native*: grounded in the model's own representations rather than imposed through external ontologies. We instantiate this view by recovering a compact orthogonal basis from sequence-level activations. The resulting basis is semantically interpretable but need not correspond to any predefined human ontology; instead, it captures axes of behavioral variation that the model itself organizes around. We validate this characterization on reasoning post-training, using the recovered basis for both SFT data selection and inference-time steering. We develop lightweight proxy interventions to identify which directions are most useful for a given model. Across Llama3-8B and Qwen2.5-3B, selecting data along those directions improves Pass@1 by up to 20% on MATH and 41% on AMC, outperforming data selection based on human-characterized skills. Because the basis lives in activation space, the same directions also serve as steering vectors at inference time, improving Pass@8 by up to 4.8% on MATH--an intervention that human-characterized skills cannot support. We further validate the characterization on safety alignment, where selecting adversarial training data for model-native skill coverage rather than textual diversity yields more sample-efficient learning. These results suggest that recovering skills from the model's own representations, rather than imposing them externally, provides a more effective foundation for intervening on model behavior. Codes are open-sourced.

Standard evaluation protocols reveal a counterintuitive phenomenon: on 7.7% of benchmark problems spanning five datasets, larger language models underperform smaller ones by 28.4 percentage points despite 10-100x more parameters. Through systematic evaluation of 31 models (0.5B-405B parameters) across 1,485 problems, we identify the mechanism as spontaneous scale-dependent verbosity that introduces errors through overelaboration. Causal intervention experiments demonstrate this reflects correctable prompt design rather than fundamental capability limitations. Constraining large models to produce brief responses improves accuracy by 26 percentage points and reduces performance gaps by up to two-thirds. Most critically, brevity constraints completely reverse performance hierarchies on mathematical reasoning and scientific knowledge benchmarks, with large models achieving 7.7-15.9 percentage point advantages over small models -- direct inversions of the original gaps. These reversals prove large models possess superior latent capabilities that universal prompting masks. We validate findings through three independent contamination tests and demonstrate inverse scaling operates continuously across the full parameter spectrum, with dataset-specific optimal scales ranging from 0.5B to 3.0B parameters. Our results establish that maximizing large model performance requires scale-aware prompt engineering rather than universal evaluation protocols, with immediate implications for deployment: prompt adaptation simultaneously improves accuracy and reduces computational costs.

The growing demand for mental health support has highlighted the importance of conversational agents as human supporters worldwide and in China. These agents could increase availability and reduce the relative costs of mental health support. The provided support can be divided into two main types: cognitive and emotional support. Existing work on this topic mainly focuses on constructing agents that adopt Cognitive Behavioral Therapy (CBT) principles. Such agents operate based on pre-defined templates and exercises to provide cognitive support. However, research on emotional support using such agents is limited. In addition, most of the constructed agents operate in English, highlighting the importance of conducting such studies in China. In this study, we analyze the effectiveness of Emohaa in reducing symptoms of mental distress. Emohaa is a conversational agent that provides cognitive support through CBT-based exercises and guided conversations. It also emotionally supports users by enabling them to vent their desired emotional problems. The study included 134 participants, split into three groups: Emohaa (CBT-based), Emohaa (Full), and control. Experimental results demonstrated that compared to the control group, participants who used Emohaa experienced considerably more significant improvements in symptoms of mental distress. We also found that adding the emotional support agent had a complementary effect on such improvements, mainly depression and insomnia. Based on the obtained results and participants' satisfaction with the platform, we concluded that Emohaa is a practical and effective tool for reducing mental distress.

Emotional support conversation aims at reducing the emotional distress of the help-seeker, which is a new and challenging task. It requires the system to explore the cause of help-seeker's emotional distress and understand their psychological intention to provide supportive responses. However, existing methods mainly focus on the sequential contextual information, ignoring the hierarchical relationships with the global cause and local psychological intention behind conversations, thus leads to a weak ability of emotional support. In this paper, we propose a Global-to-Local Hierarchical Graph Network to capture the multi-source information (global cause, local intentions and dialog history) and model hierarchical relationships between them, which consists of a multi-source encoder, a hierarchical graph reasoner, and a global-guide decoder. Furthermore, a novel training objective is designed to monitor semantic information of the global cause. Experimental results on the emotional support conversation dataset, ESConv, confirm that the proposed GLHG has achieved the state-of-the-art performance on the automatic and human evaluations. The code will be released in here \small{~https://github.com/pengwei-iie/GLHG}.

Reinforcement learning with verifiable rewards is typically performed on-policy, keeping training data close to the current policy but limiting learning to trajectories that the policy can discover itself. Off-policy methods such as supervised fine-tuning, on the other hand, can leverage external knowledge beyond the base model's capabilities, but may suffer from large distribution shift. The key challenge is thus to expand exploration without sacrificing learnability. In this work, we introduce Minimal Intervention Reinforcement Learning (MInTRL), which expands the exploration frontier through sparse, local interventions in otherwise on-policy rollouts. During generation, a judge-intervention policy periodically reviews the current policy's output, replaces erroneous suffixes with short corrections, and immediately returns control to the policy. During training, MInTRL adopts a sequence-level advantage-regression objective that eliminates the need for importance sampling. We show that sparse, local interventions can substantially improve coverage beyond finite-budget on-policy sampling while preserving the overall on-policy nature of the resulting trajectories. Across math and code benchmarks, MInTRL consistently outperforms standard on-policy and off-policy baselines. Ablations show that MInTRL remains effective with self-intervention and across different judge policies, while performance peaks at moderate intervention intensity, highlighting the importance of intervening minimally. These results establish minimal intervention as an effective paradigm for enhancing on-policy RL.

Sparsely-activated Mixture-of-experts (MoE) models allow the number of parameters to greatly increase while keeping the amount of computation for a given token or a given sample unchanged. However, a poor expert routing strategy (e.g. one resulting in load imbalance) can cause certain experts to be under-trained, leading to an expert being under or over-specialized. Prior work allocates a fixed number of experts to each token using a top-k function regardless of the relative importance of different tokens. To address this, we propose a heterogeneous mixture-of-experts employing an expert choice method. Instead of letting tokens select the top-k experts, we have experts selecting the top-k tokens. As a result, each token can be routed to a variable number of experts and each expert can have a fixed bucket size. We systematically study pre-training speedups using the same computational resources of the Switch Transformer top-1 and GShard top-2 gating of prior work and find that our method improves training convergence time by more than 2x. For the same computational cost, our method demonstrates higher performance in fine-tuning 11 selected tasks in the GLUE and SuperGLUE benchmarks. For a smaller activation cost, our method outperforms the T5 dense model in 7 out of the 11 tasks.

Text-based causal inference increasingly employs textual data as proxies for unobserved confounders, yet this approach introduces a previously undertheorized source of bias: treatment leakage. Treatment leakage occurs when text intended to capture confounding information also contains signals predictive of treatment status, thereby inducing post-treatment bias in causal estimates. Critically, this problem can arise even when documents precede treatment assignment, as authors may employ future-referencing language that anticipates subsequent interventions. Despite growing recognition of this issue, no systematic methods exist for identifying and mitigating treatment leakage in text-as-confounder applications. This paper addresses this gap through three contributions. First, we provide formal statistical and set-theoretic definitions of treatment leakage that clarify when and why bias occurs. Second, we propose four text distillation methods -- similarity-based passage removal, distant supervision classification, salient feature removal, and iterative nullspace projection -- designed to eliminate treatment-predictive content while preserving confounder information. Third, we validate these methods through simulations using synthetic text and an empirical application examining International Monetary Fund structural adjustment programs and child mortality. Our findings indicate that moderate distillation optimally balances bias reduction against confounder retention, whereas overly stringent approaches degrade estimate precision.

We consider the problem of ranking n experts based on their performances on d tasks. We make a monotonicity assumption stating that for each pair of experts, one outperforms the other on all tasks. We consider the sequential setting where in each round, the learner has access to noisy evaluations of actively chosen pair of expert-task, given the information available up to the actual round. Given a confidence parameter delta in (0, 1), we provide strategies allowing to recover the correct ranking of experts and develop a bound on the total number of queries made by our algorithm that hold with probability at least 1 -- delta. We show that our strategy is adaptive to the complexity of the problem (our bounds are instance dependent), and develop matching lower bounds up to a poly-logarithmic factor. Finally, we adapt our strategy to the relaxed problem of best expert identification and provide numerical simulation consistent with our theoretical results.

Standard Retrieval-Augmented Generation (RAG) systems predominantly rely on semantic relevance as a proxy for utility. However, this assumption collapses in realistic decision-making scenarios where user queries are laden with cognitive biases, such as false premises or confirmation bias. In such cases, maximizing relevance paradoxically promotes the retrieval of sycophantic evidence that reinforces hallucinations, a critical failure we term the ``Relevance-Robustness Gap''. To bridge this gap, we propose CoRM-RAG (Counterfactual Risk Minimization for RAG), a framework that aligns retrieval with decision safety rather than mere similarity. Grounded in causal intervention, we introduce a Cognitive Perturbation Protocol to simulate user biases during training, which is then distilled into a lightweight Evidence Critic. This scoring module learns to identify documents that possess sufficient evidential strength to steer the model toward correctness despite adversarial query perturbations. Extensive experiments on decision-making benchmarks demonstrate that CoRM-RAG significantly outperforms strong dense retrievers and LLM-based rerankers in adversarial settings, while enabling effective risk-aware abstention through reliable robustness scoring. Our code is available at https://github.com/PeiYangLiu/CoRM-RAG.git.

Background: Agent skills are increasingly deployed as modular, reusable capability units in AI agent systems. Medical research agent skills require safeguards beyond general-purpose evaluation, including scientific integrity, methodological validity, reproducibility, and boundary safety. This study developed and preliminarily evaluated a domain-specific audit framework for medical research agent skills, with a focus on reliability against expert review. Methods: We developed MedSkillAudit (skill-auditor@1.0), a layered framework assessing skill release readiness before deployment. We evaluated 75 skills across five medical research categories (15 per category). Two experts independently assigned a quality score (0-100), an ordinal release disposition (Production Ready / Limited Release / Beta Only / Reject), and a high-risk failure flag. System-expert agreement was quantified using ICC(2,1) and linearly weighted Cohen's kappa, benchmarked against the human inter-rater baseline. Results: The mean consensus quality score was 72.4 (SD = 13.0); 57.3% of skills fell below the Limited Release threshold. MedSkillAudit achieved ICC(2,1) = 0.449 (95% CI: 0.250-0.610), exceeding the human inter-rater ICC of 0.300. System-consensus score divergence (SD = 9.5) was smaller than inter-expert divergence (SD = 12.4), with no directional bias (Wilcoxon p = 0.613). Protocol Design showed the strongest category-level agreement (ICC = 0.551); Academic Writing showed a negative ICC (-0.567), reflecting a structural rubric-expert mismatch. Conclusions: Domain-specific pre-deployment audit may provide a practical foundation for governing medical research agent skills, complementing general-purpose quality checks with structured audit workflows tailored to scientific use cases.

Mental health disorders are rising worldwide. However, the availability of trained clinicians has not scaled proportionally, leaving many people without adequate or timely support. To bridge this gap, recent studies have shown the promise of Artificial Intelligence (AI) to assist mental health diagnosis, monitoring, and intervention. However, the development of efficient, reliable, and ethical AI to assist clinicians is heavily dependent on high-quality clinical training datasets. Despite growing interest in data curation for training clinical AI assistants, existing datasets largely remain scattered, under-documented, and often inaccessible, hindering the reproducibility, comparability, and generalizability of AI models developed for clinical mental health care. In this paper, we present the first comprehensive survey of clinical mental health datasets relevant to the training and development of AI-powered clinical assistants. We categorize these datasets by mental disorders (e.g., depression, schizophrenia), data modalities (e.g., text, speech, physiological signals), task types (e.g., diagnosis prediction, symptom severity estimation, intervention generation), accessibility (public, restricted or private), and sociocultural context (e.g., language and cultural background). Along with these, we also investigate synthetic clinical mental health datasets. Our survey identifies critical gaps such as a lack of longitudinal data, limited cultural and linguistic representation, inconsistent collection and annotation standards, and a lack of modalities in synthetic data. We conclude by outlining key challenges in curating and standardizing future datasets and provide actionable recommendations to facilitate the development of more robust, generalizable, and equitable mental health AI systems.