We propose a new approach to multi-factor classification of natural language texts based on weighted structured patterns such as N-grams, taking into account the heterarchical relationships between them, applied to solve such a socially impactful problem as the automation of detection of specific cognitive distortions in psychological care, relying on an interpretable, robust and transparent artificial intelligence model. The proposed recognition and learning algorithms improve the current state of the art in this field. The improvement is tested on two publicly available datasets, with significant improvements over literature-known F1 scores for the task, with optimal hyper-parameters determined, having code and models available for future use by the community.

Text-based automated Cognitive Distortion detection is a challenging task due to its subjective nature, with low agreement scores observed even among expert human annotators, leading to unreliable annotations. We explore the use of Large Language Models (LLMs) as consistent and reliable annotators, and propose that multiple independent LLM runs can reveal stable labeling patterns despite the inherent subjectivity of the task. Furthermore, to fairly compare models trained on datasets with different characteristics, we introduce a dataset-agnostic evaluation framework using Cohen's kappa as an effect size measure. This methodology allows for fair cross-dataset and cross-study comparisons where traditional metrics like F1 score fall short. Our results show that GPT-4 can produce consistent annotations (Fleiss's Kappa = 0.78), resulting in improved test set performance for models trained on these annotations compared to those trained on human-labeled data. Our findings suggest that LLMs can offer a scalable and internally consistent alternative for generating training data that supports strong downstream performance in subjective NLP tasks.

As interest grows in applying natural language processing (NLP) techniques to mental health, an expanding body of work explores the automatic detection and classification of cognitive distortions (CDs). CDs are habitual patterns of negatively biased or flawed thinking that distort how people perceive events, judge themselves, and react to the world. Identifying and addressing them is a central goal of therapy. Despite this momentum, the field remains fragmented, with inconsistencies in CD taxonomies, task formulations, and evaluation practices limiting comparability across studies. This survey presents the first comprehensive review of 38 studies spanning two decades, mapping how CDs have been implemented in computational research and evaluating the methods applied. We provide a consolidated CD taxonomy reference, summarise common task setups, and highlight persistent challenges to support more coherent and reproducible research. Alongside our review, we introduce practical resources, including curated evaluation metrics from surveyed papers, a standardised datasheet template, and an ethics flowchart, available online.

Cognitive distortions have been closely linked to mental health disorders, yet their automatic detection remained challenging due to contextual ambiguity, co-occurrence, and semantic overlap. We proposed a novel framework that combines Large Language Models (LLMs) with Multiple-Instance Learning (MIL) architecture to enhance interpretability and expression-level reasoning. Each utterance was decomposed into Emotion, Logic, and Behavior (ELB) components, which were processed by LLMs to infer multiple distortion instances, each with a predicted type, expression, and model-assigned salience score. These instances were integrated via a Multi-View Gated Attention mechanism for final classification. Experiments on Korean (KoACD) and English (Therapist QA) datasets demonstrate that incorporating ELB and LLM-inferred salience scores improves classification performance, especially for distortions with high interpretive ambiguity. Our results suggested a psychologically grounded and generalizable approach for fine-grained reasoning in mental health NLP.

Rising mental health issues among youth have increased interest in automated approaches for detecting early signs of psychological distress in digital text. One key focus is the identification of cognitive distortions, irrational thought patterns that have a role in aggravating mental distress. Early detection of these distortions may enable timely, low-cost interventions. While prior work has focused on English clinical data, we present the first in-depth study of cross-lingual and cross-register generalization of cognitive distortion detection, analyzing forum posts written by Dutch adolescents. Our findings show that while changes in language and writing style can significantly affect model performance, domain adaptation methods show the most promise.

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.

In recent years, there has been growing interest in studying cognitive distortions and emotional appraisals from both computational and psychological perspectives. Despite considerable similarities between emotional reappraisal and cognitive reframing as emotion regulation techniques, these concepts have largely been examined in isolation. This research explores the relationship between cognitive distortions and emotional appraisal dimensions, examining their potential connections and relevance for future interdisciplinary studies. Under this pretext, we conduct an exploratory computational study, aimed at investigating the relationship between cognitive distortion and emotional appraisals. We show that the patterns of statistically significant relationships between cognitive distortions and appraisal dimensions vary across different distortion categories, giving rise to distinct appraisal profiles for individual distortion classes. Additionally, we analyze the impact of cognitive restructuring on appraisal dimensions, exemplifying the emotion regulation aspect of cognitive restructuring.

Mental health issues are worsening in today's competitive society, such as depression and anxiety. Traditional healings like counseling and chatbots fail to engage effectively, they often provide generic responses lacking emotional depth. Although large language models (LLMs) have the potential to create more human-like interactions, they still struggle to capture subtle emotions. This requires LLMs to be equipped with human-like adaptability and warmth. To fill this gap, we propose the MIND (Multi-agent INner Dialogue), a novel paradigm that provides more immersive psychological healing environments. Considering the strong generative and role-playing ability of LLM agents, we predefine an interactive healing framework and assign LLM agents different roles within the framework to engage in interactive inner dialogues with users, thereby providing an immersive healing experience. We conduct extensive human experiments in various real-world healing dimensions, and find that MIND provides a more user-friendly experience than traditional paradigms. This demonstrates that MIND effectively leverages the significant potential of LLMs in psychological healing.

Traditional in-person psychological counseling remains primarily niche, often chosen by individuals with psychological issues, while online automated counseling offers a potential solution for those hesitant to seek help due to feelings of shame. Cognitive Behavioral Therapy (CBT) is an essential and widely used approach in psychological counseling. The advent of large language models (LLMs) and agent technology enables automatic CBT diagnosis and treatment. However, current LLM-based CBT systems use agents with a fixed structure, limiting their self-optimization capabilities, or providing hollow, unhelpful suggestions due to redundant response patterns. In this work, we utilize Quora-like and YiXinLi single-round consultation models to build a general agent framework that generates high-quality responses for single-turn psychological consultation scenarios. We use a bilingual dataset to evaluate the quality of single-response consultations generated by each framework. Then, we incorporate dynamic routing and supervisory mechanisms inspired by real psychological counseling to construct a CBT-oriented autonomous multi-agent framework, demonstrating its general applicability. Experimental results indicate that AutoCBT can provide higher-quality automated psychological counseling services.

This research explores a hybrid approach to fine-tuning large language models (LLMs) by integrating real-world and synthetic data to boost model performance, particularly in generating accurate and contextually relevant responses. By leveraging a dataset combining transcribed real interactions with high-quality synthetic sessions, we aimed to overcome the limitations of scarce, noisy, and domain-specific real data. Synthetic personas and scenarios were employed to enhance training diversity. The study evaluated three models: a base foundational model, a model fine-tuned with real data, and a hybrid fine-tuned model. Experimental results showed that the hybrid model consistently outperformed the others in specific vertical applications, achieving the highest scores across all metrics. Further testing confirmed the hybrid model's superior adaptability and contextual understanding across diverse scenarios. These findings suggest that combining real and synthetic data can significantly improve the robustness and contextual sensitivity of LLMs, particularly in domain-specific and vertical use cases.