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Although advances in large language models (LLMs) offer potential for more flexible interactions, their lack of controllability and explanability poses challenges in high-stakes contexts like psychotherapy. To address this, we conducted two studies in this work to explore how aligning LLMs with expert-crafted scripts can enhance psychotherapeutic chatbot performance. In Study 1 (N=43), an online experiment with a within-subjects design, we compared rule-based, pure LLM, and LLMs aligned with expert-crafted scripts via fine-tuning and prompting. Results showed that aligned LLMs significantly outperformed the other types of chatbots in empathy, dialogue relevance, and adherence to therapeutic principles. Building on findings, we proposed ''Script-Strategy Aligned Generation (SSAG)'', a more flexible alignment approach that reduces reliance on fully scripted content while maintaining LLMs' therapeutic adherence and controllability. In a 10-day field Study 2 (N=21), SSAG achieved comparable therapeutic effectiveness to full-scripted LLMs while requiring less than 40% of expert-crafted dialogue content. Beyond these results, this work advances LLM applications in psychotherapy by providing a controllable and scalable solution, reducing reliance on expert effort. By enabling domain experts to align LLMs through high-level strategies rather than full scripts, SSAG supports more efficient co-development and expands access to a broader context of psychotherapy.<\/jats:p>","DOI":"10.1145\/3757655","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T16:59:10Z","timestamp":1760633950000},"page":"1-41","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Script-Strategy Aligned Generation: Aligning LLMs with Expert-Crafted Dialogue Scripts and Therapeutic Strategies for Psychotherapy"],"prefix":"10.1145","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8188-7576","authenticated-orcid":false,"given":"Xin","family":"Sun","sequence":"first","affiliation":[{"name":"University of Amsterdam, Amsterdam, Netherlands and National Institute of Informatics (NII), Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7299-7992","authenticated-orcid":false,"given":"Jan","family":"de Wit","sequence":"additional","affiliation":[{"name":"Tilburg University, Tilburg, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5474-6949","authenticated-orcid":false,"given":"Zhuying","family":"Li","sequence":"additional","affiliation":[{"name":"Southeast University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6951-8340","authenticated-orcid":false,"given":"Jiahuan","family":"Pei","sequence":"additional","affiliation":[{"name":"Vrije Universiteit Amsterdam, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9954-4088","authenticated-orcid":false,"given":"Abdallah","family":"El Ali","sequence":"additional","affiliation":[{"name":"Centrum Wiskunde &amp; Informatica (CWI), Amsterdam, Netherlands and Utrecht University, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7780-4806","authenticated-orcid":false,"given":"Jos A.","family":"Bosch","sequence":"additional","affiliation":[{"name":"University of Amsterdam, Amsterdcam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"320","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_1_1_1","unstructured":"2023. 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