THERAPY · LONG-TERM CONDITIONS

Online therapy for long-term health conditions

When a condition becomes part of daily life, the mental load can be as heavy as the physical one. Specialist online therapy for UK adults living with chronic illness.

Living with a long-term condition is a job in itself

A long-term condition reshapes daily life in ways most people around you don’t see. Medication routines, monitoring, appointments, flare-ups, fatigue, the constant background calculation of how today’s body is doing and what that means for the day ahead. By the time most people come to therapy, they’ve been carrying this for years and have rarely been offered space to think about what it costs them.

Then there’s the harder layer underneath. The grief for the version of life you thought you’d be living. The anxiety that sits in the background about progression, complications, or the next setback. The frustration with appointments that don’t go anywhere. The strain on relationships, work, plans. The slow erosion of feeling like yourself.

Therapy can’t take a long-term condition away. The work isn’t medical, and it doesn’t replace the care you have in place with your GP, consultant, or specialist team.

What therapy can do is change the relationship between you and the condition. How much room it takes up in your head as well as your body. How much of your energy goes on managing it. How much weight it has on your mood, your sleep, your relationships, and your sense of who you are now. The condition often stays present in the work. The aim is for it to take up less of you.

How I work with long-term conditions

ACT (Acceptance and Commitment Therapy) is the main approach I use. The work helps you build psychological flexibility: practical skills for moving towards what matters to you while the condition is part of the picture, rather than spending all your energy fighting it or trying to think your way out of it. There’s strong evidence behind ACT for people living with chronic illness, and it’s where most modern therapy in this area is headed.

EMDR (Eye Movement Desensitisation and Reprocessing) comes in where it fits. Long-term conditions often come tangled with trauma: a frightening diagnosis, a hospital admission that didn’t go well, repeated dismissal in healthcare. EMDR has specific tools for working with that.

CBT (Cognitive Behavioural Therapy) shapes how I think about evidence-based practice. My BABCP accreditation grounds the wider approach in proven traditions, even as I draw on what’s most helpful for the person in front of me.

The blend depends on what you’re carrying. Many people I work with start with ACT and never need anything else. Others need a few sessions of EMDR alongside, or some classic CBT skills for sleep or worry. The work fits you.

Conditions I work with

✓Diabetes (Type 1 and Type 2)
✓Cardiac conditions, including post-MI and arrhythmias
✓Respiratory conditions, including asthma and COPD
✓Inflammatory bowel disease and IBS
✓Autoimmune and inflammatory conditions
✓ME/CFS and Long COVID
✓Skin conditions with significant life impact, including eczema and psoriasis
✓Neurological conditions, including post-stroke and MS
✓Other long-term conditions affecting daily life and mental health

If your condition isn’t listed, that doesn’t mean it isn’t a fit. The free consultation is the right place to check.

Therapy for ME/CFS and Long COVID

ME/CFS and Long COVID are real, physical conditions. They are not anxiety, they are not deconditioning, and they are not something you can think your way out of. Post-exertional malaise — the crash that follows even small amounts of activity — sits at the centre of both, and it makes them unlike most other long-term conditions. So before anything else: the therapy I offer is not a treatment for the illness itself, and it isn’t graded exercise. I won’t ask you to push through, and I won’t treat your symptoms as a problem of belief.

What therapy can help with is everything the illness drags in alongside it. The grief for the life and the energy you used to have. The disbelief — from doctors, employers, sometimes the people closest to you — and the particular kind of injury that comes from not being believed. The anxiety about whether this is permanent, whether you’ll get worse, whether you’ll be able to work. The guilt about what you can no longer do, and the identity that gets lost when your days shrink to managing symptoms. For many people, repeated dismissal in healthcare has left something closer to trauma, and EMDR can help with that specifically.

A lot of the work is about living well inside real limits rather than fighting them. ACT is well suited to this: it’s about spending less of your scarce energy in a war with your body, and protecting more of it for what actually matters to you. Where pacing is part of your management, therapy can support the emotional side of it — the frustration, the boom-and-bust, the self-criticism on bad days — without ever pretending that more activity is the cure.

Practically, online sessions are built for this. You don’t have to travel or spend a precious chunk of your energy budget getting to an appointment. We can work in shorter sessions, reschedule when you’re crashing, and go at a pace your body sets. If you’re not sure therapy is worth the energy it costs, the free consultation is a low-demand place to find out.

What we’ll actually work on

Therapy for long-term conditions isn’t generic. It works because it focuses on the specific things the condition has been doing to your daily life. The work usually covers some combination of these:

→Health anxiety and fear of flare-ups. Worry about progression, complications, or the next setback can take up more space than the condition itself. There’s a lot of useful work to do here.
→Mood, sleep, and energy. Long-term conditions disrupt all three. All three, in turn, make the condition harder to live with. We work the loop.
→Communication with healthcare. Getting more out of appointments. Asking better questions. Advocating for yourself when you’re tired of advocating.
→Relationships, work, and disclosure. Who to tell, how much, and when. Asking for adjustments. Holding onto the parts of life that matter when the condition is making demands.
→Identity and meaning. A long-term condition changes who you thought you were going to be. Therapy is one place to do the slow work of finding yourself again, with the body you have now.

Common questions about therapy for long-term conditions

Will therapy mean my condition is “all in my head”?

No. Your condition is real, and I take it seriously. I work alongside the medical care you have, not in place of it. The therapy work is about the impact the condition has on the rest of your life: your mood, sleep, sense of yourself, relationships, the things you used to do. The aim is reducing how much of you the condition takes up while taking the condition itself seriously.

I’ve had this condition for years. Is therapy still worth it now?

Yes. People often assume long-term conditions have somehow gone past the point where therapy could help. In practice the opposite tends to be true. The longer the condition has been part of your life, the more it’s likely to have affected the rest of it, and the more there is to work on. Many of the people I see have lived with their condition for years or decades before coming.

My condition fluctuates. Will therapy fit around that?

Yes. Online sessions make this easier than in-person therapy, because you don’t have to travel on a bad day. We can talk in the consultation about how to handle flare-ups: rescheduling, shorter sessions, or working on different things on harder days. Flexibility is part of how I work.

Should I still see my GP, consultant, or specialist team?

Yes. Therapy is one part of caring for a long-term condition, not a replacement for medical or specialist treatment. If you have clinicians you trust, please continue that work. With your consent, I’ll often coordinate with other professionals involved in your care, especially when there’s a treatment plan or rehabilitation programme in motion.

How long does therapy for a long-term condition usually take?

It varies. Some people come for a focused piece of work over six or eight sessions and move on. Others use therapy across a longer period, working on different aspects of living with the condition as they come up. We’ll talk through what’s likely to fit your situation in the consultation, and review as we go.

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