DMT-CBT：面向CBT咨询的纵向治疗状态建模
DMT-CBT: Longitudinal Therapeutic State Modeling for CBT Counseling
AI总结：
提出DMT-CBT框架，通过跨会话结构化治疗状态、多模态行为基础与工具增强干预，解决现有方法将CBT咨询简化为局部回复生成的问题，实现纵向治疗状态动态建模。
摘要：
大型语言模型（LLM）在认知行为疗法（CBT）咨询中展现出日益增长的潜力。然而，现有方法大多将咨询视为局部回复生成问题，专注于短文本、仅文本或单次会话交互中的共情回复。我们认为这种表述从根本上与真实心理治疗的本质不符。在临床CBT中，治疗是一个纵向过程，治疗师需要跨会话持续推断、更新和干预不断演变的治疗状态。真实的CBT还涉及多模态推理和延迟的跨会话干预效果，要求模型在部分可观测性下捕捉纵向治疗状态的演变。我们提出DMT-CBT，一个用于CBT咨询中治疗状态动态建模的框架。DMT-CBT跨会话维护结构化的治疗状态，同时整合多模态行为基础和工具增强的干预，以支持适应性治疗推理。基于该框架，我们构建了DMTCorpus，一个合成的多会话多模态CBT咨询数据集，具有演变的治疗状态、图像基础的患者行为以及跨会话干预的连续性。实验结果表明，与事后提取方法相比，DMT-CBT提高了咨询保真度和治疗联盟，产生了更有利的纵向情感轨迹，并更忠实地保留了治疗状态。
英文摘要：
Large language models (LLMs) have shown growing potential for Cognitive Behavioral Therapy (CBT) counseling. However, most existing approaches still formulate counseling as a local response generation problem, focusing on empathetic replies within short, text-only, or single-session interactions. We argue that this formulation fundamentally mismatches the nature of real psychotherapy. In clinical CBT, therapy is a longitudinal process in which therapists continuously infer, update, and intervene on evolving therapeutic states across sessions. Realistic CBT further involves multimodal inference and delayed cross-session intervention effects, requiring models to capture longitudinal therapeutic state evolution under partial observability. We propose DMT-CBT, a framework for Dynamic Modeling of evolving Therapeutic states in CBT counseling. DMT-CBT maintains structured therapeutic states across sessions while incorporating multimodal behavioral grounding and tool-augmented intervention to support adaptive therapeutic reasoning. Based on this framework, we construct DMTCorpus, a synthetic multi-session multimodal CBT counseling dataset featuring evolving therapeutic states, image-grounded client behaviors, and cross-session intervention continuity. Experimental results show that DMT-CBT improves counseling fidelity and therapeutic alliance, produces more favorable longitudinal affective trajectories, and preserves therapeutic states more faithfully than post-hoc extraction approaches.
机构、总结、中文摘要均由AI分析而来，可能存在错误，请以论文正文为准。
