Warm hands entangled in cold technology? Psychologists’ tinkering expertise in digital psychiatry

Digitalization is intended to help address the rapidly growing demand for psychiatric care by offering cost-efficient and accessible treatment. This paper examines how psychologists working in digital psychiatry enact and negotiate their professional expertise. I use a novel STS framework synthesizing the conceptual lenses of expertise and tinkering, to show how psychologists become entangled with technology, confusing divisions of labor. Moreover, I suggest that technology is neither replacing psychologists, as critics propose, nor augmenting their work, as advocates assert; it is displacing them. In this displaced position, psychologists must employ tinkering care practices that support both technology and patient self-care—what I call a meta-role. On the one hand, this role can make psychologists feel professionally redundant. On the other hand, digitalization can be seen as bolstering the psychology profession within psychiatry—a field where psychologists conventionally occupy a marginal position—because it addresses mild to moderate conditions that do not need medical interventions. Thus, the paper discusses the future epistemic domain of psychiatry and how technology, coinciding with the rise of self-help, affects professional identities. The paper is based on extensive participant observations at a digital therapy initiative and interviews with 17 psychologists working there.