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Leveraging large language models to identify microcounseling skills in psychotherapy transcripts
Department of Psychology, University of Oslo, Oslo, Norway.ORCID iD: 0009-0004-1550-2967
KTH, School of Electrical Engineering and Computer Science (EECS), Computer Science, Software and Computer systems, SCS.ORCID iD: 0000-0002-4310-0867
KTH, School of Electrical Engineering and Computer Science (EECS), Computer Science, Software and Computer systems, SCS.ORCID iD: 0000-0002-6779-7435
Braive AS, Oslo, Norway.
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2025 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, p. 1-19Article in journal (Refereed) Published
Abstract [en]

Objective: Microcounseling skills are fundamental to effective psychotherapy, yet manual coding is time- and resource-intensive. This study explores the potential of large language models (LLMs) to automate the identification of these skills in therapy sessions. Method: We fine-tuned GPT-4.1 on a set of psychotherapy transcripts annotated by human coders. The model was trained to classify therapist utterances, generate explanations for its decisions, and propose alternative responses. The pipeline included transcript preprocessing, dialogue segmentation, and supervised fine-tuning. Results: The model achieved solid performance (Accuracy: 0.78; Precision: 0.79; Recall: 0.78; F1: 0.78; Specificity: 0.77; Cohen's κ: 0.69). It reliably detected common and structurally distinct skills but struggled with more nuanced skills that rely on understanding implicit relational dynamics. Conclusion: Despite limitations, fine-tuned LLMs have potential for enhancing psychotherapy research and clinical practice by providing scalable, automated coding of therapist skills.

Place, publisher, year, edition, pages
Informa UK Limited , 2025. p. 1-19
Keywords [en]
artificial intelligence, counseling skills, large language models, machine learning, natural language processing
National Category
Applied Psychology Natural Language Processing
Identifiers
URN: urn:nbn:se:kth:diva-369938DOI: 10.1080/10503307.2025.2539405ISI: 001550802700001PubMedID: 40817802Scopus ID: 2-s2.0-105013461117OAI: oai:DiVA.org:kth-369938DiVA, id: diva2:1998889
Note

QC 20250918

Available from: 2025-09-18 Created: 2025-09-18 Last updated: 2025-09-18Bibliographically approved

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Schmidt, FabianVlassov, Vladimir

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