PatientAct: Theory-Grounded Mental Health Client Simulation

LLM-based simulated clients are increasingly used to train novice counselors, evaluate LLM therapists, and generate synthetic data. However, current simulators produce overly cooperative clients that disclose too readily, accept therapeutic reframes without resistance, and resolve core issues within a single session. We trace these issues to profiles that lack causal depth and behavioral mechanisms that treat all content as equally accessible. We present PatientAct, a framework for client simula

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ethics.ai (13 August 2026), “PatientAct: Theory-Grounded Mental Health Client Simulation,” evidence record 19454, https://ethics.ai/record/19454 (originally published by arXiv cs.HC).

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