{"id":"https://openalex.org/W7139932326","doi":"https://doi.org/10.48550/arxiv.2603.18008","title":"TherapyGym: Evaluating and Aligning Clinical Fidelity and Safety in Therapy Chatbots","display_name":"TherapyGym: Evaluating and Aligning Clinical Fidelity and Safety in Therapy Chatbots","publication_year":2026,"publication_date":"2026-02-23","ids":{"openalex":"https://openalex.org/W7139932326","doi":"https://doi.org/10.48550/arxiv.2603.18008"},"language":null,"primary_location":{"id":"doi:10.48550/arxiv.2603.18008","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2603.18008","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article"},"type":"preprint","indexed_in":["datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.48550/arxiv.2603.18008","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5110835767","display_name":"Fangrui Huang","orcid":null},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Huang, Fangrui","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130228696","display_name":"Souhad Chbeir","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Chbeir, Souhad","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5050749526","display_name":"Arpandeep Khatua","orcid":"https://orcid.org/0000-0001-9406-2322"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Khatua, Arpandeep","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130214885","display_name":"Sheng Wang","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Wang, Sheng","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130234696","display_name":"Sijun Tan","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Tan, Sijun","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130240968","display_name":"Kenan Ye","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ye, Kenan","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5022077174","display_name":"Lily Bailey","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Bailey, Lily","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130250632","display_name":"Merryn Daniel","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Daniel, Merryn","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130242955","display_name":"Ryan Louie","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Louie, Ryan","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130235339","display_name":"Sanmi Koyejo","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Koyejo, Sanmi","raw_affiliation_strings":[],"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5130240279","display_name":"Ehsan Adeli","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Adeli, Ehsan","raw_affiliation_strings":[],"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":11,"corresponding_author_ids":["https://openalex.org/A5110835767"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11519","display_name":"Digital Mental Health Interventions","score":0.9147999882698059,"subfield":{"id":"https://openalex.org/subfields/3202","display_name":"Applied Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T11519","display_name":"Digital Mental Health Interventions","score":0.9147999882698059,"subfield":{"id":"https://openalex.org/subfields/3202","display_name":"Applied Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12488","display_name":"Mental Health via Writing","score":0.05660000070929527,"subfield":{"id":"https://openalex.org/subfields/3207","display_name":"Social Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.003599999938160181,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/fidelity","display_name":"Fidelity","score":0.6791999936103821},{"id":"https://openalex.org/keywords/audit","display_name":"Audit","score":0.4846000075340271},{"id":"https://openalex.org/keywords/patient-safety","display_name":"Patient safety","score":0.4618000090122223},{"id":"https://openalex.org/keywords/scalability","display_name":"Scalability","score":0.448199987411499},{"id":"https://openalex.org/keywords/set","display_name":"Set (abstract data type)","score":0.4293999969959259},{"id":"https://openalex.org/keywords/safer","display_name":"SAFER","score":0.41600000858306885},{"id":"https://openalex.org/keywords/scale","display_name":"Scale (ratio)","score":0.3939000070095062},{"id":"https://openalex.org/keywords/pipeline","display_name":"Pipeline (software)","score":0.36469998955726624},{"id":"https://openalex.org/keywords/preference","display_name":"Preference","score":0.3634999990463257}],"concepts":[{"id":"https://openalex.org/C2776459999","wikidata":"https://www.wikidata.org/wiki/Q2119376","display_name":"Fidelity","level":2,"score":0.6791999936103821},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.5475999712944031},{"id":"https://openalex.org/C199521495","wikidata":"https://www.wikidata.org/wiki/Q181487","display_name":"Audit","level":2,"score":0.4846000075340271},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.4618000090122223},{"id":"https://openalex.org/C48044578","wikidata":"https://www.wikidata.org/wiki/Q727490","display_name":"Scalability","level":2,"score":0.448199987411499},{"id":"https://openalex.org/C177264268","wikidata":"https://www.wikidata.org/wiki/Q1514741","display_name":"Set (abstract data type)","level":2,"score":0.4293999969959259},{"id":"https://openalex.org/C2776654903","wikidata":"https://www.wikidata.org/wiki/Q2601463","display_name":"SAFER","level":2,"score":0.41600000858306885},{"id":"https://openalex.org/C2778755073","wikidata":"https://www.wikidata.org/wiki/Q10858537","display_name":"Scale (ratio)","level":2,"score":0.3939000070095062},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.3849000036716461},{"id":"https://openalex.org/C43521106","wikidata":"https://www.wikidata.org/wiki/Q2165493","display_name":"Pipeline (software)","level":2,"score":0.36469998955726624},{"id":"https://openalex.org/C2781249084","wikidata":"https://www.wikidata.org/wiki/Q908656","display_name":"Preference","level":2,"score":0.3634999990463257},{"id":"https://openalex.org/C83849319","wikidata":"https://www.wikidata.org/wiki/Q7295720","display_name":"Rating scale","level":2,"score":0.3610000014305115},{"id":"https://openalex.org/C2777363581","wikidata":"https://www.wikidata.org/wiki/Q15098235","display_name":"Harm","level":2,"score":0.35499998927116394},{"id":"https://openalex.org/C105002631","wikidata":"https://www.wikidata.org/wiki/Q4833645","display_name":"Subject-matter expert","level":3,"score":0.3458999991416931},{"id":"https://openalex.org/C113364801","wikidata":"https://www.wikidata.org/wiki/Q26674","display_name":"High fidelity","level":2,"score":0.33219999074935913},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.32589998841285706},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.29820001125335693},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.29760000109672546},{"id":"https://openalex.org/C18762648","wikidata":"https://www.wikidata.org/wiki/Q42213","display_name":"Work (physics)","level":2,"score":0.29109999537467957},{"id":"https://openalex.org/C175154964","wikidata":"https://www.wikidata.org/wiki/Q380077","display_name":"Task analysis","level":3,"score":0.2824000120162964},{"id":"https://openalex.org/C2777904410","wikidata":"https://www.wikidata.org/wiki/Q7397","display_name":"Software","level":2,"score":0.27639999985694885},{"id":"https://openalex.org/C19527891","wikidata":"https://www.wikidata.org/wiki/Q1120908","display_name":"Medical physics","level":1,"score":0.27309998869895935},{"id":"https://openalex.org/C2522767166","wikidata":"https://www.wikidata.org/wiki/Q2374463","display_name":"Data science","level":1,"score":0.26510000228881836},{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.26489999890327454},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.26429998874664307},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.25999999046325684},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.25839999318122864},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.25380000472068787},{"id":"https://openalex.org/C107457646","wikidata":"https://www.wikidata.org/wiki/Q207434","display_name":"Human\u2013computer interaction","level":1,"score":0.2531999945640564}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.48550/arxiv.2603.18008","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2603.18008","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":null,"raw_source_name":null,"raw_type":"article"}],"best_oa_location":{"id":"doi:10.48550/arxiv.2603.18008","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2603.18008","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/4","display_name":"Quality Education","score":0.5172246694564819}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Large":[0],"language":[1],"models":[2],"(LLMs)":[3],"are":[4,171],"increasingly":[5],"used":[6],"for":[7,111],"mental-health":[8],"support;":[9],"yet":[10],"prevailing":[11],"evaluation":[12],"methods--fluency":[13],"metrics,":[14],"preference":[15],"tests,":[16],"and":[17,36,45,92,113,126,176],"generic":[18],"dialogue":[19],"benchmarks--fail":[20],"to":[21,65,84,153,157,173],"capture":[22],"the":[23,51],"clinically":[24],"critical":[25],"dimensions":[26],"of":[27,104,167],"psychotherapy.":[28],"We":[29],"introduce":[30],"THERAPYGYM,":[31],"a":[32,75,101,122],"framework":[33],"that":[34,62,170],"evaluates":[35],"improves":[37],"therapy":[38,168],"chatbots":[39,169],"along":[40],"two":[41],"clinical":[42],"pillars:":[43],"fidelity":[44],"safety.":[46],"Fidelity":[47],"is":[48,72],"measured":[49],"using":[50,74],"Cognitive":[52],"Therapy":[53],"Rating":[54],"Scale":[55],"(CTRS),":[56],"implemented":[57],"as":[58,121],"an":[59],"automated":[60],"pipeline":[61],"scores":[63],"adherence":[64],"CBT":[66],"techniques":[67],"over":[68],"multi-turn":[69],"sessions.":[70],"Safety":[71],"assessed":[73],"multi-label":[76],"annotation":[77],"scheme,":[78],"covering":[79],"therapy-specific":[80],"risks":[81],"(e.g.,":[82],"failing":[83],"address":[85],"harm":[86],"or":[87],"abuse).":[88],"To":[89],"mitigate":[90],"bias":[91],"unreliability":[93],"in":[94,141,178],"LLM-based":[95],"judges,":[96],"we":[97],"further":[98],"release":[99],"THERAPYJUDGEBENCH,":[100],"validation":[102],"set":[103],"116":[105],"dialogues":[106],"with":[107,131,147],"1,270":[108],"expert":[109,145],"ratings":[110],"auditing":[112],"calibration":[114],"against":[115],"licensed":[116],"clinicians.":[117],"THERAPYGYM":[118,142],"also":[119],"serves":[120],"training":[123],"harness:":[124],"CTRS":[125,149],"safety-based":[127],"rewards":[128],"drive":[129],"RL":[130],"configurable":[132],"patient":[133],"simulations":[134],"spanning":[135],"diverse":[136],"symptom":[137],"profiles.":[138],"Models":[139],"trained":[140],"improve":[143],"on":[144],"ratings,":[146],"average":[148],"rising":[150],"from":[151],"0.10":[152],"0.60":[154],"(and":[155],"0.16":[156],"0.59":[158],"under":[159],"LLM":[160],"judges).":[161],"Our":[162],"work":[163],"enables":[164],"scalable":[165],"development":[166],"faithful":[172],"evidence-based":[174],"practice":[175],"safer":[177],"high-stakes":[179],"use.":[180]},"counts_by_year":[],"updated_date":"2026-03-21T06:36:02.116451","created_date":"2026-03-21T00:00:00"}
