Reframing Human-Centered Design in Professional Work: The Case of Digital Mental Health Platforms

Human-Centered Design (HCD), emphasizing iterative user engagement, usability, and context-specific alignment, has become a prominent framework guiding digital health innovations. However, HCD’s practical implementation often diverges from its theoretical principles. Specifically, superficial and rhetorical adoption of HCD can produce unintended adaptations driven primarily by professional convenience rather than genuine clinical and patient-centered objectives, ultimately undermining the societal value of digital innovations. This study employs Adaptive Structuration Theory for Individuals (ASTI) to explore how psychotherapists adapt a digital mental health platform to their practices, reshaping initial clinical intentions and embedded technological functionalities. Empirically, we analyze the case of "Manthera," a psychotherapy digital platform implemented in Italy. Through qualitative inquiry, we trace how superficial applications of HCD principles facilitate progressive compromises in platform design, primarily reflecting psychotherapists’ autonomy, cultural preferences, and pragmatic convenience rather than the intended clinical outcomes. Our findings extend ASTI by explicitly positioning professional logics as critical antecedents of adaptive behaviors. Additionally, we contribute to emerging debates in the HCD debate, clarifying why superficial user-centered approaches undermine clinical and societal outcomes, and reinforcing the importance of moving toward more holistic "humanity-centered" frameworks.