This research explores how multimodal LLMs can be thoughtfully integrated into campus mental health services to address rising student needs while preserving the critical therapeutic alliance.

Key Findings:

• MLLMs offer valuable mental health support opportunities when implemented at specific intervention points where they complement rather than replace human therapists
• User-centered design approach revealed both student clients and therapists have nuanced preferences for AI integration
• Careful integration preserves therapeutic alliance while addressing scaling challenges in campus mental health services
• Ethical considerations and privacy safeguards must be prioritized in any implementation

Why This Matters: College mental health services face overwhelming demand with limited resources. This research provides practical guidance for how AI can ethically supplement human care, potentially increasing access while maintaining quality therapeutic relationships.

Enhancing Psychotherapeutic Alliance in College: When and How to Integrate Multimodal Large Language Models in Psychotherapy