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Training Therapeutic Judges and Multi-Agent Systems for Human-Aligned Mental Health Support

This paper proposes a framework for therapeutic response generation driven by multi-dimensional, human-aligned evaluation. Stage I introduces TheraJudge, an open-source therapeutic evaluator trained via preference-based optimization on human-annotated data, producing reliable judgments across 7 psychological dimensions. Stage II introduces TheraAgent, which operationalizes the evaluations through a coordinated refinement process with Critic, Coach, and Therapist roles. TheraJudge achieves strong agreement with clinician ratings (ICC=0.87-0.95), and TheraAgent yields a +0.43 improvement in therapeutic quality, with low-quality responses improving by +2.45 points and a 94% recovery rate.

SourcearXiv Computational LinguisticsAuthor: Mizanur Rahman, Abeer Badawi, Elahe Rahimi, Laleh Seyyed-Kalantari, Frank Rudzicz, Enamul Hoque, Elham Dolatabadi

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[Submitted on 29 Jun 2026]

Title:Training Therapeutic Judges and Multi-Agent Systems for Human-Aligned Mental Health Support

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Abstract:Large language models show promise for mental health support, yet therapeutic quality improves only when evaluation functions as an actionable control signal rather than a passive metric. We introduce a framework that formulates therapeutic response generation as a decision-refinement problem driven by multi-dimensional, human-aligned evaluation. In Stage I, we introduce TheraJudge, an open-source therapeutic evaluator trained via preference-based optimization on human-annotated data to produce reliable judgments across 7 psychological dimensions. In Stage II, we introduce TheraAgent, which operationalizes TheraJudge's evaluations through a coordinated refinement process with specialized Critic, Coach, and Therapist roles that translate evaluative signals into targeted response revisions. Empirically, TheraJudge achieves strong agreement with clinician ratings, with intraclass correlation coefficients (ICC = 0.87-0.95), surpassing supervised baselines and strong closed-source judges, particularly on critical dimensions such as Safety, Relevance, and Empathy. Acting on these evaluations, TheraAgent yields a +0.43 improvement in human-rated therapeutic quality (on a 5-point scale) under blind evaluation, with 96\% clinician inter-rater reliability. Low-quality responses ($\leq 3$) improve by +2.45 points with a 94\% recovery rate, demonstrating targeted correction of unsafe outputs. Overall, our results indicate that effective alignment of mental-health LLMs stems from acting on human-aligned evaluation, rather than relying solely on stronger generation. We release code at this https URL.

Subjects:

Computation and Language (cs.CL); Artificial Intelligence (cs.AI); Multiagent Systems (cs.MA)

Cite as: arXiv:2606.30887 [cs.CL]

(or arXiv:2606.30887v1 [cs.CL] for this version)

https://doi.org/10.48550/arXiv.2606.30887

arXiv-issued DOI via DataCite (pending registration)

Submission history

From: Elham Dolatabadi [view email] [v1] Mon, 29 Jun 2026 20:22:25 UTC (6,483 KB)

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