Cognitive Reframing of Negative Thoughts through Human-Language Model Interaction

TL;DR

This study explores how language models can assist individuals in cognitively reframing negative thoughts, demonstrating effective generation of empathetic and specific reframes through a validated framework and a large-scale user study.

Contribution

The paper introduces a framework of seven linguistic attributes for reframing thoughts, develops automated metrics, and trains a retrieval-enhanced model to generate high-quality rephrases validated by mental health experts.

Findings

Participants prefer highly empathetic reframes

Specific reframes are more effective than overly positive ones

Language models can generate personalized, high-quality reframes

Abstract

A proven therapeutic technique to overcome negative thoughts is to replace them with a more hopeful "reframed thought." Although therapy can help people practice and learn this Cognitive Reframing of Negative Thoughts, clinician shortages and mental health stigma commonly limit people's access to therapy. In this paper, we conduct a human-centered study of how language models may assist people in reframing negative thoughts. Based on psychology literature, we define a framework of seven linguistic attributes that can be used to reframe a thought. We develop automated metrics to measure these attributes and validate them with expert judgements from mental health practitioners. We collect a dataset of 600 situations, thoughts and reframes from practitioners and use it to train a retrieval-enhanced in-context learning model that effectively generates reframed thoughts and controls their linguistic attributes. To investigate what constitutes a "high-quality" reframe, we conduct an IRB-approved randomized field study on a large mental health website with over 2,000 participants. Amongst other findings, we show that people prefer highly empathic or specific reframes, as opposed to reframes that are overly positive. Our findings provide key implications for the use of LMs to assist people in overcoming negative thoughts.