INTRODUCTION: Digital mental health interventions (DMHIs) show promise in improving children's mental health, but there is limited understanding of how technology and screen media influence treatment outcomes. The purpose of this study was to leverage retrospective data to explore the relationships of technology and screen media use with mental health symptoms among children participating in a pediatric DMHI. METHODS: Children ages 6-12 years who participated in a DMHI, Bend Health Inc, in the United States were included. Caregivers reported their child's screen media use and mental health symptoms every 30 days. Associations of screen media use with mental health symptoms were examined at baseline and throughout DMHI participation. RESULTS: Nearly all children (98.0%) used screen media, with 58.3% exhibiting problematic use and 23.2% showing elevated use at baseline. Elevated screen media use was associated with more severe depressive (z = 2.19, DISCUSSION: Findings suggest a nuanced interaction between technology use and DMHIs. Future research should explore the specific contexts of screen media use to optimize DMHI effectiveness and address the potential adverse effects of certain screen media activities.