arXiv:2606.17786cs.HCcs.CL2026-06

用AI虚拟患者模拟心理治疗训练,实时反馈干预质量。

Toward Accessible Psychotherapy Training Using AI-Driven Interactive Patient Avatars

论文配图:Toward Accessible Psychotherapy Training Using AI-Driven Interactive Patient Avatars
图 1 · 摘自论文原文
  • 用大模型生成基于真实案例的虚拟患者,支持对话式训练。
  • GPT-4o-mini反馈模型在49个案例中误差最小(MAE=6.12)。
  • 适合需要反复练习且缺乏督导资源的心理治疗学习者。

培养基于证据的心理治疗方法(如接纳与承诺疗法,ACT)需要在有意义的反馈下反复练习,但受伦理、后勤和资源限制,安全且标准化的训练机会有限。本文提出一个系统,通过语音对话与具身虚拟患者互动,支持以ACT为导向的心理治疗训练。该系统利用大语言模型,根据真实治疗会话生成的患者档案和可配置临床情景模拟患者行为;同时,独立的自动化评估器基于既定的ACT一致性标准,提供逐轮反馈。系统不旨在取代督导,而是通过低风险环境中的实验、反思与即时反馈,支持刻意练习。专家评估确认患者行为高度真实,并表明即时逐轮反馈提升了治疗师对干预选择的认知,支持尝试替代回应。对49份治疗转录文本的定量评估显示,GPT-4o-mini作为反馈模型表现最优,其平均绝对误差(MAE = 6.12)最低,与人类督导评分有统计学显著一致性。本研究证明,具备一致性意识的模拟患者可作为心理治疗培训的可扩展补充。

原文摘要 · Abstract (English)

Training psychotherapists in evidence-based interventions such as Acceptance and Commitment Therapy (ACT) requires repeated practice with meaningful feedback, yet opportunities for safe, standardized training are limited by ethical, logistical, and resource constraints. We introduce a system designed to support ACT-oriented psychotherapy training through spoken dialogue with an embodied virtual patient. The system uses large language models to simulate patient behavior conditioned on profiles derived from real therapy sessions and configurable clinical scenarios, while a separate automated evaluator provides turn-by-turn feedback on therapist responses based on established ACT fidelity criteria. Rather than aiming to replace supervision, the system is intended to support deliberate practice by enabling experimentation, reflection, and immediate feedback in low-risk settings. Expert evaluation with practicing psychologists confirmed high realism in patient behavior and demonstrated that immediate turn-by-turn ACT feedback increased therapists' awareness of intervention choices and enabled effective experimentation with alternative responses. Quantitative evaluation across 49 therapy transcripts identified GPT-4o-mini as the optimal feedback model, achieving the lowest mean absolute error (MAE = 6.12) in replicating human supervisor ACT fidelity ratings with statistically significant agreement. This work demonstrates the potential of fidelity-aware simulated patients as a scalable complement to psychotherapy training.

心理治疗AI训练虚拟患者自然语言处理

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