Conversational Topic Recommendation in Counseling and Psychotherapy with Decision Transformer and Large Language Models

Given the increasing demand for mental health assistance, artificial intelligence (AI), particularly large language models (LLMs), may be valuable for integration into automated clinical support systems. In this work, we leverage a decision transformer architecture for topic recommendation in counseling conversations between patients and mental health professionals. The architecture is utilized for offline reinforcement learning, and we extract states (dialogue turn embeddings), actions (conversation topics), and rewards (scores measuring the alignment between patient and therapist) from previous turns within a conversation to train a decision transformer model. We demonstrate an improvement over baseline reinforcement learning methods, and propose a novel system of utilizing our model's output as synthetic labels for fine-tuning a large language model for the same task. Although our implementation based on LLaMA-2 7B has mixed results, future work can undoubtedly build on the design.