There is a significant gap between patient needs and available mental health support today. In this paper, we aim to thoroughly examine the potential of using Large Language Models (LLMs) to assist professional psychotherapy. To this end, we propose a new benchmark, CBT-Bench, for the systematic evaluation of cognitive behavioral therapy (CBT) assistance. We include three levels of tasks in CBT-Bench: **I: Basic CBT knowledge acquisition**, with the task of multiple-choice questions; **II: Cognitive model understanding**, with the tasks of cognitive distortion classification, primary core belief classification, and fine-grained core belief classification; **III: Therapeutic response generation**, with the task of generating responses to patient speech in CBT therapy sessions.These tasks encompass key aspects of CBT that could potentially be enhanced through AI assistance, while also outlining a hierarchy of capability requirements, ranging from basic knowledge recitation to engaging in real therapeutic conversations. We evaluated representative LLMs on our benchmark. Experimental results indicate that while LLMs perform well in reciting CBT knowledge, they fall short in complex real-world scenarios requiring deep analysis of patients’ cognitive structures and generating effective responses, suggesting potential future work.

Mental illness remains one of the most critical public health issues. Despite its importance, many mental health professionals highlight a disconnect between their training and actual real-world patient practice. To help bridge this gap, we propose PATIENT-𝜓, a novel patient simulation framework for cognitive behavior therapy (CBT) training. To build PATIENT-𝜓, we construct diverse patient cognitive models based on CBT principles and use large language models (LLMs) programmed with these cognitive models to act as a simulated therapy patient. We propose an interactive training scheme, PATIENT-𝜓-TRAINER, for mental health trainees to practice a key skill in CBT – formulating the cognitive model of the patient – through role-playing a therapy session with PATIENT-𝜓. To evaluate PATIENT-𝜓, we conducted a comprehensive user study of 13 mental health trainees and 20 experts. The results demonstrate that practice using PATIENT-𝜓-TRAINER enhances the perceived skill acquisition and confidence of the trainees beyond existing forms of training such as textbooks, videos, and role-play with non-patients. Based on the experts’ perceptions, PATIENT-𝜓 is perceived to be closer to real patient interactions than GPT-4, and PATIENT-𝜓-TRAINER holds strong promise to improve trainee competencies. Our code and data are released at https://github.com/ruiyiw/patient-psi.