用AI模拟真实治疗场景,帮助戒瘾者长期保持动力。
ChatThero: An LLM-Supported Chatbot for Behavior Change and Therapeutic Support in Addiction Recovery
- 在模拟疗法环境中训练聊天机器人,动态注入临床策略。
- 提升用户动机和信心,效果优于GPT-5,尤其对难治型患者。
- 适合心理治疗、数字健康领域研究者与应用开发者。
物质使用障碍影响数百万人,复吸常见,需多轮干预。医疗资源有限,加剧康复支持难度。我们提出ChatThero,一种低成本、多轮次、应激感知且具备记忆持续性的自主语言代理,用于促进长期行为改变与戒瘾支持。不同于以往仅在医患对话数据上微调大模型的方法,ChatThero在多智能体模拟环境中训练,基于匿名患者资料(如Reddit康复社区)构建三类患者画像(易、中、难),并引入社会决定因素等外部应激源以模拟真实情境。动态注入动机访谈与认知行为疗法策略。人类评审员(盲评)与LLM-as-Judge评估均显示,ChatThero在共情与临床相关性上更优。应激模拟提升系统鲁棒性:显式应激导致类复吸事件,符合现实模式。行为变化评估表明,在1–5分量表上,ChatThero使动机提升+1.71分(2.39→4.10),信心提升+1.67分(1.52→3.19),显著优于GPT-5;在难治型患者中,达成成功目标所需轮次减少26%。
原文摘要 · Abstract (English)
Substance use disorders (SUDs) affect millions of people, and relapses are common, requiring multi-session treatments. Access to care is limited, which contributes to the challenge of recovery support. We present \textbf{ChatThero}, an innovative low-cost, multi-session, stressor-aware, and memory-persistent autonomous \emph{language agent} designed to facilitate long-term behavior change and therapeutic support in addiction recovery. Unlike existing work that mostly finetuned large language models (LLMs) on patient-therapist conversation data, ChatThero was trained in a multi-agent simulated environment that mirrors real therapy. We created anonymized patient profiles from recovery communities (e.g., Reddit). We classify patients as \texttt{easy}, \texttt{medium}, and \texttt{difficult}, three scales representing their resistance to recovery. We created an external environment by introducing stressors (e.g., social determinants of health) to simulate real-world situations. We dynamically inject clinically-grounded therapeutic strategies (motivational interview and cognitive behavioral therapy). Our evaluation, conducted by both human (blinded clinicians) and LLM-as-Judge, shows that ChatThero is superior in empathy and clinical relevance. We show that stressor simulation improves robustness of ChatThero. Explicit stressors increase relapse-like setbacks, matching real-world patterns. We evaluate ChatThero with behavioral change metrics. On a 1--5 scale, ChatThero raises \texttt{motivation} by $+1.71$ points (from $2.39$ to $4.10$) and \texttt{confidence} by $+1.67$ points (from $1.52$ to $3.19$), substantially outperforming GPT-5. On \texttt{difficult} patients, ChatThero reaches the success milestone with $26\%$ fewer turns than GPT-5.
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