What is it about?

Texting, messaging, and social media are central to our relationships - but they are rarely part of psychotherapy. This gap matters, especially in chronic depression, where problems in relationships show up in digital interactions just as they do face to face. We introduced a group therapy in which patients bring in their own digital interactions and, together with the group, reflect on and reshape them: the electronic situational analysis (eSA). Among 74 adults with chronic depression, most were keen to discuss their digital communication, over half joined the eSA group, and depression symptoms, social media use, and digital conflicts all decreased during treatment - with eSA participants reducing their screen time more.

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Why is it important?

This work provides one of the first structured ways to bring patients' digital interactions systematically into psychotherapy. The electronic situational analysis (eSA) helps patients communicate more intentionally online, turning their own digital interactions into ecologically valid material for change. The eSA is immediately practical (we provide working materials for clinicians in the paper) and potentially scalable to other conditions marked by interpersonal difficulties. The findings are preliminary, but they point to patients' digital interactions as a meaningful and workable target for psychotherapy.

Perspectives

Our earlier research already pushed back on the idea that digital communication and social media are inherently harmful: We found they can actually protect against loneliness in chronic depression, often most for those who feel loneliest (Wolf et al., EAPCN, 2026). Here, we go further: structurally integrating our patients' digital experiences into therapy, and reflecting on and reshaping them to foster a purposeful digital life rather than a harmful one. To me, this is where mental health care needs to go: not prohibiting or restricting digital environments, but helping people navigate them purposefully and helpfully.

Johannes Wolf
LMU University Hospital Munich

Read the Original

This page is a summary of: Addressing Interpersonal Difficulties in Digital Communication in Psychotherapy for Adults With Chronic Depression, American Journal of Psychotherapy, July 2026, American Psychiatric Association,
DOI: 10.1176/appi.psychotherapy.20260004.
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