Pretrained language models leverage self-supervised learning to use large amounts of unlabeled text for learning contextual representations of sequences. However, in the domain of medical conversations, the availability of large, public datasets is limited due to issues of privacy and data management. In this paper, we study the effectiveness of dialog-aware pretraining objectives and multiphase training in using unlabeled data to improve LMs training for medical utterance classification. The objectives of pretraining for dialog awareness involve tasks that take into account the structure of conversations, including features such as turn-taking and the roles of speakers. The multiphase training process uses unannotated data in a sequence that prioritizes similarities and connections between different domains. We empirically evaluate these methods on conversational dialog classification tasks in the medical and counseling domains, and find that multiphase training can help achieve higher performance than standard pretraining or finetuning.

Reflective listening is a fundamental skill that counselors must acquire to achieve proficiency in motivational interviewing (MI). It involves responding in a manner that acknowledges and explores the meaning of what the client has expressed in the conversation. In this work, we introduce the task of counseling response rewriting, which transforms non-reflective statements into reflective responses. We introduce VERVE, a template-based rewriting system with paraphrase-augmented training and adaptive template updating. VERVE first creates a template by identifying and filtering out tokens that are not relevant to reflections and constructs a reflective response using the template. Paraphrase-augmented training allows the model to learn less-strict fillings of masked spans, and adaptive template updating helps discover effective templates for rewriting without significantly removing the original content. Using both automatic and human evaluations, we compare our method against text rewriting baselines and show that our framework is effective in turning non-reflective statements into more reflective responses while achieving a good content preservation-reflection style trade-off.

Counselor reflection is a core verbal skill used by mental health counselors to express understanding and affirmation of the client’s experience and concerns. In this paper, we propose a system for the analysis of counselor reflections. Specifically, our system takes as input one dialog turn containing a client prompt and a counselor response, and outputs a score indicating the level of reflection in the counselor response. We compile a dataset consisting of different levels of reflective listening skills, and propose the Prompt-Aware margIn Ranking (PAIR) framework that contrasts positive and negative prompt and response pairs using specially designed multi-gap and prompt-aware margin ranking losses. Through empirical evaluations and deployment of our system in a real-life educational environment, we show that our analysis model outperforms several baselines on different metrics, and can be used to provide useful feedback to counseling trainees.

Automatic speech recognition (ASR) is a crucial step in many natural language processing (NLP) applications, as often available data consists mainly of raw speech. Since the result of the ASR step is considered as a meaningful, informative input to later steps in the NLP pipeline, it is important to understand the behavior and failure mode of this step. In this work, we analyze the quality of ASR in the psychotherapy domain, using motivational interviewing conversations between therapists and clients. We conduct domain agnostic and domain-relevant evaluations using standard evaluation metrics and also identify domain-relevant keywords in the ASR output. Moreover, we empirically study the effect of mixing ASR and manual data during the training of a downstream NLP model, and also demonstrate how additional local context can help alleviate the error introduced by noisy ASR transcripts.