Therapy as an NLP Task: Psychologists' Comparison of LLMs and Human Peers in CBT

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

Efficiently Programming Large Language Models using SGLang

Large language models (LLMs) are increasingly used for complex tasks requiring multiple chained generation calls, advanced prompting techniques, control flow, and interaction with external environments. However, efficient systems for programming and executing these applications are lacking. To bridge this gap, we introduce SGLang, a Structured Generation Language for LLMs. SGLang is designed for the efficient programming of LLMs and incorporates primitives for common LLM programming patterns. We have implemented SGLang as a domain-specific language embedded in Python, and we developed an interpreter, a compiler, and a high-performance runtime for SGLang. These components work together to enable optimizations such as parallelism, batching, caching, sharing, and other compilation techniques. Additionally, we propose RadixAttention, a novel technique that maintains a Least Recently Used (LRU) cache of the Key-Value (KV) cache for all requests in a radix tree, enabling automatic KV cache reuse across multiple generation calls at runtime. SGLang simplifies the writing of LLM programs and boosts execution efficiency. Our experiments demonstrate that SGLang can speed up common LLM tasks by up to 5x, while reducing code complexity and enhancing control.