The mismatch between the growing demand for psychological counseling and the limited availability of services has motivated research into the application of Large Language Models (LLMs) in this domain. Consequently, there is a need for a robust and unified benchmark to assess the counseling competence of various LLMs. Existing works, however, are limited by unprofessional client simulation, static question-and-answer evaluation formats, and unidimensional metrics. These limitations hinder their effectiveness in assessing a model's comprehensive ability to handle diverse and complex clients. To address this gap, we introduce \textbf{CARE-Bench}, a dynamic and interactive automated benchmark. It is built upon diverse client profiles derived from real-world counseling cases and simulated according to expert guidelines. CARE-Bench provides a multidimensional performance evaluation grounded in established psychological scales. Using CARE-Bench, we evaluate several general-purpose LLMs and specialized counseling models, revealing their current limitations. In collaboration with psychologists, we conduct a detailed analysis of the reasons for LLMs' failures when interacting with clients of different types, which provides directions for developing more comprehensive, universal, and effective counseling models.

Generative artificial intelligence (Generative AI) is transforming healthcare. With this evolution comes optimism regarding the impact it will have on mental health, as well as concern regarding the risks that come with generative AI operating in the mental health domain. Much of the investment in, and academic and public discourse about, AI-powered solutions for mental health has focused on therapist chatbots. Despite the common assumption that chatbots will be the most impactful application of GenAI to mental health, we make the case here for a lower-risk, high impact use case: leveraging generative AI to enhance and scale training in mental health service provision. We highlight key benefits of using generative AI to help train people to provide mental health services and present a real-world case study in which generative AI improved the training of veterans to support one another's mental health. With numerous potential applications of generative AI in mental health, we illustrate why we should invest in using generative AI to support training people in mental health service provision.

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

Although there is a growing belief that LLMs can be used as therapists, exploring LLMs' capabilities and inefficacy, particularly from the client's perspective, is limited. This work focuses on a client-centered assessment of LLM therapists with the involvement of simulated clients, a standard approach in clinical medical education. However, there are two challenges when applying the approach to assess LLM therapists at scale. Ethically, asking humans to frequently mimic clients and exposing them to potentially harmful LLM outputs can be risky and unsafe. Technically, it can be difficult to consistently compare the performances of different LLM therapists interacting with the same client. To this end, we adopt LLMs to simulate clients and propose ClientCAST, a client-centered approach to assessing LLM therapists by client simulation. Specifically, the simulated client is utilized to interact with LLM therapists and complete questionnaires related to the interaction. Based on the questionnaire results, we assess LLM therapists from three client-centered aspects: session outcome, therapeutic alliance, and self-reported feelings. We conduct experiments to examine the reliability of ClientCAST and use it to evaluate LLMs therapists implemented by Claude-3, GPT-3.5, LLaMA3-70B, and Mixtral 8*7B. Codes are released at https://github.com/wangjs9/ClientCAST.

In practice, training using federated learning can be orders of magnitude slower than standard centralized training. This severely limits the amount of experimentation and tuning that can be done, making it challenging to obtain good performance on a given task. Server-side proxy data can be used to run training simulations, for instance for hyperparameter tuning. This can greatly speed up the training pipeline by reducing the number of tuning runs to be performed overall on the true clients. However, it is challenging to ensure that these simulations accurately reflect the dynamics of the real federated training. In particular, the proxy data used for simulations often comes as a single centralized dataset without a partition into distinct clients, and partitioning this data in a naive way can lead to simulations that poorly reflect real federated training. In this paper we address the challenge of how to partition centralized data in a way that reflects the statistical heterogeneity of the true federated clients. We propose a fully federated, theoretically justified, algorithm that efficiently learns the distribution of the true clients and observe improved server-side simulations when using the inferred distribution to create simulated clients from the centralized data.

We present a federated learning approach for learning a client adaptable, robust model when data is non-identically and non-independently distributed (non-IID) across clients. By simulating heterogeneous clients, we show that adding learned client-specific conditioning improves model performance, and the approach is shown to work on balanced and imbalanced data set from both audio and image domains. The client adaptation is implemented by a conditional gated activation unit and is particularly beneficial when there are large differences between the data distribution for each client, a common scenario in federated learning.