Iryna Gurevych
Publications
ODRA: Synthesizing Cognitive Behavioral Therapy Sessions with Structured Chain-Of-Thought and Dynamic Patient Resistance
Synthetic generation of Cognitive Behavioral Therapy (CBT) sessions is challenged by two competing demands: adhering to strict therapeutic structure while modeling the resistant, unpredictable behavior of real patients. Existing script-based methods fail to capture dynamic therapeutic interactions, while multi-agent approaches struggle to adhere to CBT's sequential structure; both suffer from sycophancy, producing overly compliant patients that misrepresent real clinical settings. In this work we introduce ODRA, a novel framework for synthesizing therapy dialogues through a Chain-of-Thought (CoT) strategy grounded in foundational CBT guidelines (Beck, 2020). ODRA further incorporates a resistance orchestrator to solve patient sycophancy, which employs steering techniques to elicit behaviors aligned with their resistance level. Automated and expert evaluations show that ODRA significantly outperforms existing methods across therapeutic skills, CBT alignment, and patient behavioral fidelity, with licensed psychologists preferring ODRA sessions across 12 of 13 clinical metrics. Furthermore, models fine-tuned on our dataset demonstrate superior therapeutic performance against both cooperative and resistant patients, validating that explicit resistance modeling in synthetic training data directly translates to downstream clinical robustness.
Sparse Autoencoders Encode Both Concepts and Functions: The Downstream Geometry of Feature Effects
The wide-scale use of sparse autoencoders (SAEs) as interpretability tools is limited by inconsistent links between SAE features and model behavior. Features with clear activation descriptions may have weak or unexpected causal effects; steering can vary across prompts or oppose the intended direction; and activation-based feature selection can miss features that produce the desired output change. Prior work has studied feature geometry inside the model, where features are computed. We instead study the geometry of changes in model logits caused by feature interventions. We introduce Feature-Effect Geometry Analysis (FEGA), an unsupervised framework that removes the same active SAE feature across contexts and analyzes the resulting cloud of logit changes. Across SAE variants, consistent one-dimensional effects are rare: few features behave like reusable directions. To interpret this variation, we distinguish value-like features, tied to static information such as factual attributes, from pointer-like features, associated with context-dependent operations. Value-like features more often exhibit structured, low-dimensional effects, although these effects typically span several directions. Pointer-like features, by contrast, predominantly exhibit diffuse effects. Our results show that a feature can be interpretable and causally relevant without providing a stable direction for steering.
Responsible Evaluation of AI for Mental Health
Although artificial intelligence (AI) shows growing promise for mental health care, current approaches to evaluating AI tools in this domain remain fragmented and poorly aligned with clinical practice, social context, and first-hand user experience. This paper argues for a rethinking of responsible evaluation -- what is measured, by whom, and for what purpose -- by introducing an interdisciplinary framework that integrates clinical soundness, social context, and equity, providing a structured basis for evaluation. Through an analysis of 135 recent *CL publications, we identify recurring limitations, including over-reliance on generic metrics that do not capture clinical validity, therapeutic appropriateness, or user experience, limited participation from mental health professionals, and insufficient attention to safety and equity. To address these gaps, we propose a taxonomy of AI mental health support types -- assessment-, intervention-, and information synthesis-oriented -- each with distinct risks and evaluative requirements, and illustrate its use through case studies.