Therapy for Long Term Illness

Support for the emotional side of living with a long-term condition, with an accredited therapist, from home by secure video.

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Accredited therapists Fully confidential Evening & weekend times

Everything is confidentialWhat you say in a session stays in the session.

Secure video, Ireland-wideFrom wherever you feel comfortable, on any device.

No GP referral neededBook online in a couple of minutes.

Evening and weekend timesSessions that fit around work and family.

Living with a condition that is not going to clear up next week asks something of you every day. The appointments. The medication. The pacing. The explaining yourself to people who think you look grand. Even when the medical side is well managed, the emotional weight of it often goes unnoticed, including by you.

Online therapy gives that weight somewhere to go without another trip across town, another waiting room, another morning spent recovering from the effort of getting there. Sessions happen by secure video, from wherever you are comfortable, anywhere in Ireland.

One thing to be clear about from the start. Therapy sits alongside your medical care, it does not replace it. Your GP and your specialist team manage your diagnosis, your treatment and your medication. A therapist works with how you are coping and what has changed. If something about your physical health is worrying you, that conversation belongs with your medical team.

Why can living with a long-term illness affect my mental health?

Long-term or chronic usually means a condition that lasts months or years rather than days, and is managed rather than cured. Diabetes, MS, arthritis, Crohn’s, endometriosis, ME, long Covid, heart and lung conditions, cancer and what follows it. Some bring persistent pain. Some bring fatigue that sleep does not touch. Some bring symptoms that behave differently every week, which is its own kind of hard.

What comes with that emotionally is very common: anxiety about what is next, low mood, grief for the life you had planned, anger, isolation, the loss of independence that comes with reduced mobility, relationships that have quietly changed shape, and real worry about work and money.

Physical symptoms and emotional wellbeing pull on each other. Pain and broken sleep lower your tolerance for everything else, and worry tightens the body and makes pain harder to sit with. That is not the same as your symptoms being in your mind. Your symptoms are real. What therapy can change is how much room the distress takes up around them.

Signs it may be worth talking to someone:

Distress that has settled in and stayed, rather than coming and going
Pulling back from people, plans or things you used to enjoy
Still not able to take in a diagnosis months after getting it
Dread in the days before appointments, scans or results
Feeling you cannot cope, or that you are only holding it together for everyone else

The HSE’s guide to getting talk therapy is a plain starting point if you want to see what exists more broadly.

How can online therapy help me cope with my condition?

Mostly by giving the illness somewhere to be talked about properly. Not the medical detail, the rest of it.

The work usually covers adjusting to a diagnosis or a change in it, processing grief and anger, saying what you need to a partner or an employer without having to over-explain, pacing without guilt, and being less hard on yourself on the bad days. Living a life you recognise alongside the condition, rather than waiting for it to be over first.

Approach	What it tends to focus on
Cognitive behavioural therapy (CBT)	Noticing the thought patterns that feed worry and low mood, then practical steps to try between sessions
Acceptance and commitment therapy (ACT)	Making room for what cannot be changed while staying connected to what still matters to you
Mindfulness-based work	Attention, breathing and noticing thoughts without fighting them; often used alongside pain management
Supportive counselling	Regular space to talk it through, with someone who keeps track of your week

Does it work on a screen? Based on available research, psychological therapy delivered remotely is generally found to be broadly comparable to the same therapy in a room for difficulties like anxiety and depression, provided it is delivered properly by a qualified therapist. Remote and digitally delivered forms of CBT sit among the recommended options in NICE clinical guidance for depression and anxiety. Evidence specific to chronic illness populations is more mixed and depends heavily on the condition, so nobody can promise you an outcome. What can be said is that this is a recognised effective way to attend, not a second-best one.

Therapy works best here as part of the wider picture. Your medical team looks after treatment; your therapist looks after how you are managing. With your consent, the two can be joined up.

Not sure if this is the right fit?

A first session is just a conversation.

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Can online therapy work around pain, fatigue and unpredictable symptoms?

This is where online quietly earns its keep. You attend from your own chair, your own bed if that is where you are, with no travel either side and no energy spent on getting anywhere.

Things that can be arranged, and which you should ask about rather than push through:

Shorter sessions if fifty minutes is too much
A planned break partway through
Camera off, or an audio or phone session, on a hard day
Fortnightly instead of weekly during treatment
Rescheduling during a flare-up without it being a problem

Sessions can be set around treatment cycles, hospital appointments, work and caring responsibilities, including evenings and weekends. Booking takes about two minutes online and you do not need a GP letter for counselling in Ireland.

The honest snags: screen fatigue is real, privacy at home is not always easy, and broadband in parts of the country is patchy. Say all of that out loud in the first session. Headphones help. So does a parked car, or a phone session when the video keeps freezing.

How do I find the right online therapist in Ireland?

Start with accreditation. Look for a therapist accredited with a recognised Irish body, for example the Irish Association for Counselling and Psychotherapy for counsellors and psychotherapists, or the Psychological Society of Ireland for psychologists, and check they are insured to work online.

Then ask the specific questions:

Have you worked with people living with chronic illness, chronic pain or disability before?
Do you have experience of medical trauma, grief, or adjusting to a diagnosis?
How do you usually work, and what would that look like week to week?
What times do you have, and how do you handle cancellations when I am unwell?
Can you work with my accessibility needs, and with my GP or team if I give consent?

Use an initial consultation for exactly this. You are there to see whether you can talk to this person, not to perform being a good patient. Language, availability and plain personal fit matter as much as the approach on paper.

How much does online therapy cost, and can I get free or low-cost support?

Private online therapy in Ireland is charged per session, and fees vary a fair bit between therapists depending on their qualification and experience. Check the current fee directly with the practice before you book rather than relying on a figure you read somewhere else.

Route	Worth knowing
Private online therapy	Quickest to start, you choose the therapist, paid per session
Through your GP	Your GP can discuss your mental health and refer or signpost you to HSE services such as primary care psychology or counselling, subject to eligibility and what is available locally
Charities and community services	Free or reduced-cost counselling, including condition-specific support from illness charities; availability is uneven around the country
Work, college or an employee assistance programme	Often a set number of free sessions, usually arranged confidentially by phone

If you have private health insurance, read the small print rather than the headline. Check the number of sessions covered per year, whether your therapist is on the approved list, any excess, and whether you claim back after paying or the provider bills directly.

One thing that catches people out. The Long-Term Illness Scheme and the Drugs Payment Scheme are about the cost of approved medicines, medical and surgical appliances for listed conditions. They are not a route to funded private therapy, so do not count on them for this.

While you are waiting for anything on a list, keep going with the ordinary things that help: your GP, one person you can be honest with, gentle movement if your condition allows it, and a rough routine. If you are in immediate danger, that is an emergency, and the contacts at the end of this page are for exactly that.

Frequently asked questions

What happens during an online therapy session?

A private video link arrives by email, with nothing to install. You join at your appointment time and talk for about fifty minutes, starting wherever you want to start. A first session usually covers what brought you, what has been going on with your health, and what you would like to be different. Sometimes you leave with something small to notice or try before the next one, sometimes it is just about talking it through.

How does online therapy compare with face-to-face counselling?

For most people it feels more similar than they expect after a session or two. The research picture, as far as it goes, suggests broadly comparable results for common difficulties. What differs is the practical side: no travel, no waiting room, and you are somewhere familiar, which many people with fatigue or pain find makes the difference between attending and cancelling.

Is online therapy private, secure and confidential in Ireland?

Sessions take place over an encrypted video link, and accredited therapists work to the confidentiality standards of their professional body, with the usual limits where there is a risk of serious harm. Your therapist will explain those limits at the start. A few practical points to sort on your end:

Use headphones if anyone else is home
Pick the most private spot you have, even if that is a parked car
Tell your therapist if you are somewhere you cannot speak freely

How can I take the next step?

If any of this sounds like where you are, you can book an initial online session whenever you feel ready, or talk it over with your GP first if that feels like the better starting point. Either is fine.

When you book, mention what you need up front: shorter sessions, an audio option, times that avoid your treatment days, or anything about pain and fatigue that affects when you can talk. It is much easier to build the sessions around that from the beginning than to renegotiate later.

Online therapy is not an emergency service. If you are in crisis or at immediate risk:

Call 999 or 112, or go to your nearest emergency department
Contact your GP or the out-of-hours GP service
Samaritans, freephone 116 123, any hour of the day
Pieta, freephone 1800 247 247, for thoughts of suicide or self-harm
Text About It, text 50808, if talking on the phone is not possible