Media coverage of research on phones and social media over the last decade has prompted widespread concern and one-size-fits-all guidance to limit screen time. Recognizing the limitations of screen time as a metric, researchers are now studying technology use in terms of affordances, individual differences, and longitudinal patterns. The current review examines technology use by parents, caregivers, couples, and clinicians. Individuals in these roles navigate risks, such as privacy violations, with benefits such as improved communication, empathy, and progress toward shared goals. Successful approaches vary by relationship type but have commonalities such as engaging with the technologies used by the other person to open up sensitive conversations, negotiate conflict, and illuminate patterns that would otherwise be hard to detect. To enhance relationships, some individuals depart from the intended use of technologies, for example, adapting connected devices for emotional communication or drawing on games to cope with social anxiety. One promising way in which individuals adapt technology to improve communication involves sharing technologies that were designed for personal use. This review highlights the importance of context, motivation, and the nuances of use to understand how technologies can be optimally used in personal and clinical relationships.