Simulating human clients in mental health counseling is crucial for training and evaluating counselors (both human or simulated) in a scalable manner. Nevertheless, past research on client simulation did not focus on complex conversation tasks such as mental health counseling. In these tasks, the challenge is to ensure that the client’s actions (i.e., interactions with the counselor) are consistent with with its stipulated profiles and negative behavior settings. In this paper, we propose a novel framework that supports consistent client simulation for mental health counseling. Our framework tracks the mental state of a simulated client, controls its state transitions, and generates for each state behaviors consistent with the client’s motivation, beliefs, preferred plan to change, and receptivity. By varying the client profile and receptivity, we demonstrate that consistent simulated clients for different counseling scenarios can be effectively created. Both our automatic and expert evaluations on the generated counseling sessions also show that our client simulation method achieves higher consistency than previous methods.

Conversational counselor agents have become essential tools for addressing the rising demand for scalable and accessible mental health support. This paper introduces CAMI, a novel automated counselor agent grounded in Motivational Interviewing (MI) – a client-centered counseling approach designed to address ambivalence and facilitate behavior change. CAMI employs a novel STAR framework, consisting of client’s state inference, motivation topic exploration, and response generation modules, leveraging large language models (LLMs). These components work together to evoke change talk, aligning with MI principles and improving counseling outcomes for diverse clients. We evaluate CAMI’s performance through both automated and expert evaluations, utilizing simulated clients to assess MI skill competency, client’s state inference accuracy, topic exploration proficiency, and overall counseling success. Results show that CAMI not only outperforms several state-of-the-art methods but also shows more realistic counselor-like behavior. Additionally, our ablation study underscores the critical roles of state inference and topic exploration in achieving this performance.