Ekta Raj


2025

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Do Large Language Models Align with Core Mental Health Counseling Competencies?
Viet Cuong Nguyen | Mohammad Taher | Dongwan Hong | Vinicius Konkolics Possobom | Vibha Thirunellayi Gopalakrishnan | Ekta Raj | Zihang Li | Heather J. Soled | Michael L. Birnbaum | Srijan Kumar | Munmun De Choudhury
Findings of the Association for Computational Linguistics: NAACL 2025

The rapid evolution of Large Language Models (LLMs) presents a promising solution to the global shortage of mental health professionals. However, their alignment with essential counseling competencies remains underexplored. We introduce CounselingBench, a novel NCMHCE-based benchmark evaluating 22 general-purpose and medical-finetuned LLMs across five key competencies. While frontier models surpass minimum aptitude thresholds, they fall short of expert-level performance, excelling in Intake, Assessment & Diagnosis but struggling with Core Counseling Attributes and Professional Practice & Ethics. Surprisingly, medical LLMs do not outperform generalist models in accuracy, though they provide slightly better justifications while making more context-related errors. These findings highlight the challenges of developing AI for mental health counseling, particularly in competencies requiring empathy and nuanced reasoning. Our results underscore the need for specialized, fine-tuned models aligned with core mental health counseling competencies and supported by human oversight before real-world deployment. Code and data associated with this manuscript can be found at: https://github.com/cuongnguyenx/CounselingBench