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Multi-dimensional Assessment and Explainable Feedback for Counselor Responses to Client Resistance in Text-based Counseling with LLMs

Anqi Li, Ruihan Wang, Zhaoming Chen, Yuqian Chen, Yu Lu, Yi Zhu, Yuan Xie, Zhenzhong Lan · Feb 25, 2026 · Citations: 0

Abstract

Effectively addressing client resistance is a sophisticated clinical skill in psychological counseling, yet practitioners often lack timely and scalable supervisory feedback to refine their approaches. Although current NLP research has examined overall counseling quality and general therapeutic skills, it fails to provide granular evaluations of high-stakes moments where clients exhibit resistance. In this work, we present a comprehensive pipeline for the multi-dimensional evaluation of human counselors' interventions specifically targeting client resistance in text-based therapy. We introduce a theory-driven framework that decomposes counselor responses into four distinct communication mechanisms. Leveraging this framework, we curate and share an expert-annotated dataset of real-world counseling excerpts, pairing counselor-client interactions with professional ratings and explanatory rationales. Using this data, we perform full-parameter instruction tuning on a Llama-3.1-8B-Instruct backbone to model fine-grained evaluative judgments of response quality and generate explanations underlying. Experimental results show that our approach can effectively distinguish the quality of different communication mechanisms (77-81% F1), substantially outperforming GPT-4o and Claude-3.5-Sonnet (45-59% F1). Moreover, the model produces high-quality explanations that closely align with expert references and receive near-ceiling ratings from human experts (2.8-2.9/3.0). A controlled experiment with 43 counselors further confirms that receiving these AI-generated feedback significantly improves counselors' ability to respond effectively to client resistance.

Human Data Lens

  • Uses human feedback: No
  • Feedback types: None
  • Rater population: Domain Experts
  • Unit of annotation: Unknown
  • Expertise required: Medicine

Evaluation Lens

  • Evaluation modes: Automatic Metrics
  • Agentic eval: None
  • Quality controls: Not reported
  • Confidence: 0.35
  • Flags: low_signal, possible_false_positive

Research Summary

Contribution Summary

  • Effectively addressing client resistance is a sophisticated clinical skill in psychological counseling, yet practitioners often lack timely and scalable supervisory feedback to refine their approaches.
  • Although current NLP research has examined overall counseling quality and general therapeutic skills, it fails to provide granular evaluations of high-stakes moments where clients exhibit resistance.
  • In this work, we present a comprehensive pipeline for the multi-dimensional evaluation of human counselors' interventions specifically targeting client resistance in text-based therapy.

Why It Matters For Eval

  • Although current NLP research has examined overall counseling quality and general therapeutic skills, it fails to provide granular evaluations of high-stakes moments where clients exhibit resistance.
  • In this work, we present a comprehensive pipeline for the multi-dimensional evaluation of human counselors' interventions specifically targeting client resistance in text-based therapy.

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