用大模型从治疗对话自动生成个性化心理网络,助力临床决策。
Using Large Language Models to Create Personalized Networks From Therapy Sessions
- 通过上下文学习识别对话中的心理过程及其维度
- 构建分层聚类与解释增强关系,生成可解释网络
- 专家评估显示90%更偏好该方法,临床相关性评分72-75%
近期心理治疗研究聚焦于个性化干预,如基于个性化网络选择治疗模块。但估计个性化网络通常需大量纵向数据,难以实现。本研究提出端到端流程,从77份治疗转录文本自动构建客户心理网络,支持个案概念化与治疗规划。我们标注了3364个心理过程及其对应维度,并利用上下文学习联合识别过程与维度,即使少量样本也表现优异。通过两步法将过程聚类为临床有意义的组别,并生成带解释的关系。专家评估显示,多步方法生成的网络在临床效用与可解释性上优于直接提示,高达90%的专家偏好该方法。网络获专家积极评价,临床相关性、新颖性与实用性评分均在72-75%之间。结果证明了利用LLM从治疗对话生成临床相关网络的可行性。优势包括从客户语句出发的自下而上概念化及潜在主题发现。该流程生成的网络可用于临床实践、督导与培训。未来研究应检验其是否比统计估计网络等其他个性化方法提升治疗效果。
原文摘要 · Abstract (English)
Recent advances in psychotherapy have focused on treatment personalization, such as by selecting treatment modules based on personalized networks. However, estimating personalized networks typically requires intensive longitudinal data, which is not always feasible. A solution to facilitate scalability of network-driven treatment personalization is leveraging LLMs. In this study, we present an end-to-end pipeline for automatically generating client networks from 77 therapy transcripts to support case conceptualization and treatment planning. We annotated 3364 psychological processes and their corresponding dimensions in therapy transcripts. Using these data, we applied in-context learning to jointly identify psychological processes and their dimensions. The method achieved high performance even with a few training examples. To organize the processes into networks, we introduced a two-step method that grouped them into clinically meaningful clusters. We then generated explanation-augmented relationships between clusters. Experts found that networks produced by our multi-step approach outperformed those built with direct prompting for clinical utility and interpretability, with up to 90% preferring our approach. In addition, the networks were rated favorably by experts, with scores for clinical relevance, novelty, and usefulness ranging from 72-75%. Our findings provide a proof of concept for using LLMs to create clinically relevant networks from therapy transcripts. Advantages of our approach include bottom-up case conceptualization from client utterances in therapy sessions and identification of latent themes. Networks generated from our pipeline may be used in clinical settings and supervision and training. Future research should examine whether these networks improve treatment outcomes relative to other methods of treatment personalization, including statistically estimated networks.
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