06/11/2025
Mental Health of
Young People in the Digital Age
NPCE Event 2025
How are children and adolescents coping mentally in the digital age? And what influence do social media platforms have on their mental health and wellbeing?
This was the central question at this year’s symposium of the Network for Psychotherapeutic Care in Europe (NPCE), chaired by Vice President Dr. Nikolaus Melcop form the Federal Chamber of Psychotherapists in Germany. Across Europe, policymakers and professionals are debating how to ensure that children and young people can use the internet and social media safely and how they can be effectively protected from harm.
A ban on social media for minors under 14, mandatory age verification, smartphone restrictions in schools, platform designs that avoids addictive mechanisms? What is the right approach? The shared challenges have long reached the highest political levels in Europe. Following her re-election as President of the European Commission, Ursula von der Leyen announced that the impact of internet and especially social media use on the mental health of children and adolescents would be a key priority for the new Commission. In her State of the Union statement, she went on to declare that a panel of experts would be appointed to examine how the use of social media by minors could be restricted. EU ministers recently adopted conclusions emphasizing that, while the internet and social media can foster greater connectedness and communication among young people, this potential must be matched by strong prevention, enhanced digital health literacy, and robust regulation to reduce the risks of excessive or harmful use.
Are Snapchat and TikTok Inherently Dangerous?
The mental health of Europe’s children and adolescents has been under stress since the COVID-19 pandemic, explained Mag. Dr. Karin Kalteis, Austrian psychotherapist and chair of the Psychotherapy Section of the Austrian Psychological Association, in her presentation. Seventy-five percent of all mental disorders emerge during childhood or adolescence. Especially in the teenage years, a complex mix of physiological, psychological and social factors increases young people’s vulnerability.
Children and adolescents today grow up in a digital world, and social media has become an integral part of their everyday lives. This does not only have negative effects. Online, young people can experience a sense of belonging, connect with peers who share their interests, and interact within more diverse social groups than they might encounter offline. In this sense, social media can also provide safe spaces for self-expression, acceptance and social support.
At the same time, intensive social media use can pose risks to healthy psychological development. Unrealistic body ideals, cyberbullying, exposure to violent or pornographic content, and the constant fear of missing out all contribute to psychological stress and may increase the likelihood of anxiety disorders, depression, eating disorders or addictive behaviours. The role of influencers, too, must be seen from both sides: while many act as authentic, positive role models who can even contribute to health education, others portray unrealistic lifestyles and spread misleading or harmful health and nutrition advice.
To ensure that children and adolescents can participate safely and meaningfully in the digital world, individual risk and protective factors must be considered. Personal characteristics such as pre-existing mental health problems, low self-esteem, impulsive behaviour or maladaptive coping strategies can increase vulnerability. Risk is also heightened by environmental factors such as low socio-economic status, lack of family support or uncontrolled media access. On the contrary, protective factors include self-confidence, positive motivation, digital literacy and the ability to deal constructively with challenging experiences. A supportive social network, active parental involvement and clear rules for media use all strengthen resilience. According to Dr Kalteis, an effective combination of behavioural and structural prevention is therefore essential. Individual resources must be fostered while environmental conditions are shaped in ways that allow young people to benefit from the opportunities of digital media use and minimise potential risks.
Austria Focuses on Low-Threshold Support for Children and Adolescents
In Austria, around ten percent of girls and seven percent of boys report problematic social media us; an issue that plays a major role in everyday clinical practice. Policymakers have also taken action: since 2022, the Austrian Ministry of Health has funded a programme that offers young people quick and uncomplicated access to quality-assured psychological care. The goal is to provide early treatment for mental distress and emerging disorders. Children and adolescents seeking help are matched with clinical psychologists or psychotherapists, and their individual needs are assessed. They then receive psychoeducation or up to 15 sessions of individual or group therapy. Demand for the programme has been high, prompting the Ministry to extend and expand its funding twice. According to Mag. Dr. Kalteis, the ultimate aim is to integrate this model into regular care structures.
Learning Mental Health Literacy Through Play: Finland Leads the Way
Associate Professor Dr. Katariina Keinonen from the University of Jyväskylä, Finland, presented research on the effectiveness of digital interventions for children and adolescents. Building on successful experiences with adults, recent studies show that technology-supported programmes can also be effective for young people, especially as usability and design quality have improved rapidly. This opens up opportunities to provide age-appropriate, engaging tools to strengthen mental health and resilience.
Keinonen explained that many current research and development projects are integrating psychological interventions directly into everyday school life. Programmes such as Feeling Good (for ages 7–12), Youth Compass (for those 13 and older) and Student Compass (for university students) teach practical skills to enhance resilience and mental health from primary school through higher education. Finland’s national curriculum explicitly includes competencies for promoting mental health and resilience as part of general education and life skills. The approach follows a competence-based model with tiered levels of support: all pupils learn fundamental skills to strengthen mental well-being and can access low-threshold support services. More intensive interventions, such as group training, counselling by school psychologists or targeted psychotherapy, are offered individually as needed. According to Keinonen, the key lies in the intelligent use and distribution of available resources. Professionals from psychology, psychotherapy and education collaborate to provide context-specific support and create a sustainable network of mental health care within schools.
Online Games for Better Mental Health? Yes, It’s Possible!
Another innovative approach in Finland involves online games designed to promote psychological flexibility among children and adolescents. Supported by the Finnish Centre for Social and Health Organisations, these games aim to introduce play- and group-based training programmes in schools and provide teacher training for their use. Interactive, story-based games, combining puzzles with relatable everyday scenarios, help children understand how to maintain and strengthen their mental health. The gameplay serves as a vivid metaphor, motivating students to reflect on what they learn. A teacher’s guide supports classroom discussions, and the entire concept was developed collaboratively with children and teachers, who continue to contribute to its evolution. Initial results show that consistent, repeated use is crucial to the success of digital interventions.
The five-week online programme Youth Compass, which introduces new resilience-focused content each week, has proven particularly effective. Co-created with young people, it includes videos featuring peers, comic strips, chatbot dialogues and game-like sequences within a visualised storyline. This interactive design enhances motivation and engagement while helping participants embed new skills into their daily routines. Outcomes include improved well-being and life satisfaction, reduced stress, strengthened resilience to school-related challenges, and a greater sense of connection to school and future aspirations. Importantly, adolescents with more pronounced symptoms seem to benefit the most, even when interventions are delivered in school rather than in clinical settings. Supplementary materials, such as teacher manuals, facilitate classroom integration and encourage use by school psychologists, counsellors and psychotherapists. Supported by the Research Council of Finland and the Finnish Cultural Foundation, the programme is currently being piloted in English-language schools in Finland and is now also available in Finnish and Swedish.
Keinonen emphasised that digital interventions can be a powerful complement to traditional therapy, especially where resources are limited. However, she also stressed the need for further research and careful implementation. Psychotherapists and other professionals must remain closely involved in decision-making processes, as there is no one-size-fits-allsolution and success cannot be guaranteed.
The individual needs of young people must be assessed carefully, and the effectiveness of digital programmes must be continuously evaluated. Most importantly, the introduction of universal digital tools must never come at the expense of personal support, whether in schools or in therapeutic care. The goal, she concluded, is to combine direct human interaction with digital innovation to create effective, sustainable support systems for mental health.
Joint European Actions are urgently needed
Across Europe, the picture is similar: experts and policymakers are observing the same challenges and feel the same urgency to act. The participants agreed that protecting the mental health of children and adolescents in the digital age requires joint European commitment as well as coordinated action within the Member States. Various approaches are already being debated — from stricter age verification and time limits on social media use to school restrictions and platform design that discourages addictive behaviour. Yet, as the discussions made clear, limiting risk alone is not enough. Europe must also ensure that digital participation remains possible and that the internet becomes a safe, supportive and empowering space for young people to grow, connect and express themselves.
Demystifying Personalisation: A Necessary Component of Digitally Led Psychological Applications
Digital tools can also be very helpful in enhancing treatment. Dr. Vasilis S. Vasiliou, clinical psychologist and lecturer at the Department of Psychology, Royal Holloway at the University of London, introduced a pressing topic during the event: How can psychological and psychotherapeutic interventions become more personal, adaptive, and effective in a digital era? His presentation “Demystifying Personalisation – A Necessary Component of Digitally Led Psychological Applications” examined the limits of protocol-driven treatment and made a compelling case for process-based, data-informed personalisation in psychological and psychotherapeutic practice.
Using the example of “Nic,” a patient whose depression improved only partially after standard cognitive behavioural therapy (CBT), Vasiliou illustrated a common dilemma: while treatment outcomes may look successful in research terms, many patients still feel emotionally stuck or disconnected. The reason, he argued, lies in the dominance of protocol-based, nomothetic approaches that assume uniform responses across individuals. Such models ensure methodological fidelity but fail to capture the variability and uniqueness of human experience. Treating individuals as averages, therefore can be a problem. In contrast, idiographic and personalised approaches focus on individual behavioural, emotional and cognitive patterns. Yet, these often rely too heavily on clinicians’ intuition, lacking structure and replicability. The challenge, therefore, is to find a scientifically grounded middle ground, a systematic way to personalise therapy.
Personalisation is not a single concept but a continuum ranging from clinical tailoring (adjusting therapy to a diagnosis) to fully individualised models that integrate clients’ goals, preferences, and progress. Research increasingly confirms that tailoring therapy to clients’ needs improves outcomes. Still, there are too many effective choices and a process framework is needed, so that therapists are guided by mechanisms of change.
Process-Based Therapy (PBT) can be the solution: a transdiagnostic, contextual and data-informed approach. PBT shifts focus from disorders to core biopsychosocial processes of change, asking “What processes should be targeted with this client, for this goal, in this situation? And how can they be changed most efficiently? Instead of standardised symptom reduction, PBT centres on contextual, longitudinal understanding of each client’s life and aims to nudge adaptive change in real time. Digital tools such as apps and wearables can track these daily nudges, providing ecologically valid data on how emotions, thoughts, motivations, and behaviours fluctuate in everyday life.
Using PBT, therapists can design interventions that are both scientifically grounded and personally meaningful. Ongoing functional network analyses allow continuous feedback and adaptation during therapy. To illustrate the approach in practice, Vasiliou presented a doctoral study conducted under his supervision: The project applied PBT to adolescents with chronic headaches. Five young participants completed the programme. Over several weeks, they received tailored online sessions and tracked daily experiences such as pain intensity, coping strategies, and progress toward personal goals. Results showed consistent improvements in personalised outcomes and wellbeing. The study demonstrated how daily variability can be captured digitally. Insights that traditional outcome measures often miss.
Vasiliou concluded that personalisation is not about intuition or preference alone, but about understanding and influencing the processes that sustain change in individuals’ unique contexts. Digital tools can help bring therapy closer to clients’ real lives, creating interventions that are adaptive, continuous and genuinely personal.
09/07/2024
NPCE
Event 2024: Digitalization
and Artificial Intelligence in Psychotherapy
How do digitalization of healthcare and artificial intelligence tools affect psychotherapeutic care in Europe? This question has been discussed with experts at the annual event of the Network for Psychotherapeutic Care (NPCE) on 29 May 2024.
Dr. Nikolaus Melcop, Vice President of the German Federal Chamber of Psychotherapists (BPtK), opened the event and explained that recently adopted EU Health Data Space Regulation has created a set of rules that enables the exchange of digital health data across Europe. It also facilitates the use of data for research purposes. This is particularly important for the development of AI-based applications in healthcare. Digitalisation in healthcare is necessary. However, digital applications must be proven to be effective and safe. First and foremost, digitalisation in healthcare must benefit patients - and not only commercial interests, Dr. Melcop said. Moreover, digital applications can only improve mental healthcare if they are embedded in local psychotherapeutic care. Regarding the use of artificial intelligence in psychotherapy, it needs to be scrutinized in how far and to which extent such tools can be used, and which ethical aspects need to be considered.
AI in psychotherapy? Not today, but in the future.
Prof. Dr. Harald Baumeister, University of Ulm, respond to this question. The psychological psychotherapist undertakes various research on digital applications in mental healthcare, especially in psychotherapeutic care. He pointed out that the development of AI-based applications has been taking place since the 1950s. However, when we talk about AI-based applications in psychotherapeutic care today, these are usually not actual AI applications, but merely algorithms. AI has therefore not yet played a role in psychotherapeutic care. In the future, AI-based chatbots and digital health applications could supplement psychotherapeutic care. But so far, there is no or not sufficient evidence of their effectiveness and safety. Prospectively, in the field of diagnostics AI tools could also assist psychotherapists. Baumeister underlined that ethical aspects must be considered while developing AI tools and their implementation. It must be assured that AI applications are transparent, that they do not reproduce discrimination and do not lead to misinterpretations. However, legal standards on data protection and privacy also influence how AI applications are developed. In view of the large investments being made by the USA and Asian countries, AI applications will primarily be developed out of commercial interests. Still, AI offers the opportunity to gain new insights into mental illnesses and can facilitate the development of individualized treatments, i.e. even more precise psychotherapeutic treatment. In the discussion of the participants of the event, the question arose which risks need to be taken into account when using AI in psychotherapy. The participants agreed that it is important for the profession to be continuously involved in AI development from the outset, in testing AI applications, and to be able to assess which AI applications are potentially indicated and safe for patients.
Digitalisation can support psychotherapeutic treatment
In her presentation, Maria Karekla, University of Cyprus, pointed out that study results always describe an average patient. This means that individual aspects that could be important for treatment get lost. However, the individual perspective must also be stronger considered in treatment. Patients perceive differentiated symptoms in everyday life but are not always able to address them in the psychotherapy session. As a result, psychotherapists cannot include these important insights in the treatment of a patient. A solution is digitally supported monitoring and documentation. By using a digital application patients can note down at any time how they feel and which symptoms arise. This can be analysed and thus, incorporated into treatment by psychotherapists. There are already many digital applications that can be used for this purpose. One example is smoking cessation. Digital applications could help to classify the patient's experiences and problems when quitting smoking and keep up the patient’s motivation. In Karekla’s view, virtual realities could also be a means of simulating certain challenging situations in psychotherapy in the future. It could be used to directly instruct patients on how to overcome or deal with specific situations. The range of digital applications, from apps to virtual reality, is wide and could offer opportunities for mental healthcare. However, if these tools are beneficial for patient treatment will depend on their further development.
Identification of safe and beneficial digital applications by guidelines
The participants then exchanged views on current developments in European countries. The use of digital applications and the development of new products are progressing continuously. The market is primarily determined by the industry, which develops and launches products very quickly. At this pace, it seems impossible for public research and development to keep up. It is therefore essential for psychotherapists to have knowledge and guidelines that enable them to identify evidence-based digital applications that are safe and useful for patients. Then, they can decide whether digital tools can be used in psychotherapeutic care.