Multi-Session Client-Centered Treatment Outcome Evaluation in Psychotherapy

Abstract

In psychotherapy, therapeutic outcome assessment, or treatment outcome evaluation, is essential to mental health care by systematically evaluating therapeutic processes and outcomes. Existing large language model approaches often focus on therapist-centered, single-session evaluations, neglecting the client's subjective experience and longitudinal progress across multiple sessions. To address these limitations, we propose IPAEval, a client-Informed Psychological Assessment-based Evaluation framework, which automates treatment outcome evaluations from the client's perspective using clinical interviews. It integrates cross-session client-contextual assessment and session-focused client-dynamics assessment for a comprehensive understanding of therapeutic progress. Specifically, IPAEval employs a two-stage prompt scheme that maps client information onto psychometric test items, enabling interpretable and structured psychological assessments. Experiments on our new TheraPhase dataset, comprising 400 paired initial and completion stage client records, demonstrate that IPAEval effectively tracks symptom severity and treatment outcomes over multiple sessions, outperforming baseline approaches across both closed-source and open-source models, and validating the benefits of items-aware reasoning mechanisms.