Reviewed byPolina BelovaPsychologist · updated 11.11.2026
Key facts
- Who provides it
- A psychotherapist or clinical psychologist experienced in working with families of people with addiction; a psychiatrist joins if there are signs of depression or an anxiety disorder
- Format
- Individual sessions in person in Almaty or online, a weekly group for relatives, and a consultation with an addiction physician to understand the illness
- Duration
- Each session lasts 50–60 minutes; a course is usually 10–20 sessions and a group runs for 2–3 months or longer; the first improvements in how you feel usually appear within 4–6 weeks
- Confidentiality
- Your loved one will not learn about your visits unless you decide to tell them; medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
- When it is urgent
- If the person with the addiction threatens you or uses violence, or if you have thoughts of death, call 112; for an overdose, seizures or delirium in your loved one, call 103
- Outcome
- Less anxiety and guilt, restored sleep and social life, clear boundaries, and an understanding of what you can and cannot change
What to know
The person who comes to my office is often not the patient but his mother or wife. She tells me how she drove at night from Medeu to Raiymbek Avenue looking for her son, how she pays off his loans, how she lies to his boss that he is “a bit unwell.” She came to ask how to cure him. But twenty minutes into the conversation it turns out that she herself hasn’t slept properly for months, has lost weight, stopped seeing her friends and lives from one phone call to the next. That is what codependency looks like.
Codependency is not a diagnosis in ICD-10. It describes the state of a relative whose whole life has become subordinate to someone else’s addiction. It is not a weakness of character: anyone who lives for a long time next to drinking binges or compulsive gambling starts to control, rescue and hide things. Codependency support is not about how to persuade your loved one to get treatment; it is about how you can stop being worn down. Paradoxically, this is often exactly what changes the behavior of the person with the addiction too.
Signs of Codependency in a Family Member
- you constantly check your loved one’s phone, pockets, banking apps and taxi routes
- you pay off their debts and loans even though you promised yourself you would stop
- you lie to relatives and their employer to cover up a binge or a gambling loss
- your mood depends entirely on whether they are sober today
- you have given up your own plans, hobbies and rest because “I can’t leave them alone”
- you feel guilty about their relapses and think you are not trying hard enough
- you have developed insomnia, headaches, blood pressure spikes or constant irritability
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
Where Codependency Comes From
A loved one’s addiction is chronic stress that lasts for years. The mind looks for a way to regain control: if I keep watch, hide the bottles and take away the bank cards, I can prevent disaster. Sometimes this really does help in the moment, and that is how the habit of rescuing takes hold. Gradually, care turns into overcontrol, and responsibility for an adult shifts onto a relative who can neither leave nor change the situation.
In Almaty families, codependency is often reinforced by cultural expectations: “what will people say,” “don’t wash your dirty linen in public,” “a mother must endure.” Shame, and sometimes direct pressure from older relatives, makes it hard to step out of the rescuer role. Another factor is financial entanglement: a shared mortgage, loans or a family business. None of this makes you guilty, but it explains why it is so hard to break the cycle without outside support.
How Codependency Therapy Works
The first session is about your story: how long the addiction has lasted, what you have already tried and how your health has changed. The therapist assesses your condition and, if anxiety or depression is significant, suggests a consultation with a psychiatrist. Then you work through specific situations together: what to do when he calls drunk, how to refuse to give money, how to talk to the children. If it is more convenient, the first sessions can take place online; many relatives call from their car in the parking lot at work or from home while their loved one is out.
Codependency support does not replace emergency measures. If your loved one is in a serious condition, with seizures, confusion, hallucinations or a suspected overdose, call 103 immediately. If you are being threatened or there is violence, call 112 and find a safe place; joint sessions with an abuser are never held in such cases. If you yourself are having thoughts of suicide, that calls for urgent help, not another session next week.
How we help
Individual Psychotherapy
We work with your thoughts and feelings: guilt, fear and the anger you have grown used to suppressing. We use methods from cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT): you learn to separate what you can control from what is beyond your power. The goal is not to stop loving your family member, but to stop living their life instead of your own. Sessions are held weekly, with small, concrete homework assignments.
Support Group for Relatives
Meetings of 6–10 people whose loved ones have an addiction. Many hear their own story from someone else for the first time and realize they are not alone and not going crazy. The group is led by a psychotherapist, and confidentiality rules are mandatory. The group complements individual work well and helps you get through periods when your loved one refuses treatment. Meetings are held in the evening so you can make it after work.
Psychoeducation About Addiction
An addiction physician or psychotherapist explains how addiction works, why promises of “I’ll never do it again” don’t hold, and what withdrawal, cravings and relapse are. When a relative understands the mechanism of the illness, it becomes easier to stop seeing a relapse as a personal betrayal. This is not a consultation on how to force someone into treatment, but knowledge that relieves some of the guilt and fear.
Boundaries and Safety Planning
Together we put into words what you will no longer do: give money, call their boss, bail them out of debt. And what you will do: take care of yourself, your children and your health. If there is a risk of aggression, we draw up a safety plan: where to go, whom to call, which documents to keep at hand. Boundaries are not a punishment but a condition that keeps you from falling apart.
How treatment works
- 01Call or WhatsAppThe administrator and the doctor on duty clarify the situation and tell you what to do right now.
- 02Examination or consultationThe doctor visits your home, sees you at the clinic or joins by video.
- 03Treatment planWe choose the format — at home, inpatient, psychotherapy or rehab — with a clear price.
- 04Ongoing supportYour doctor and psychotherapist stay in touch: follow-ups, family support and relapse prevention.
Myths and facts
MythIf I try harder, he’ll stop drinking
FactAddiction is an illness, and its course is not determined by how hard relatives try. Control and rescuing often delay the moment when a person faces the consequences themselves. Your energy is better spent on your own health and on clear boundaries.
MythCodependent people don’t need help; it’s the person with the addiction who needs treatment
FactRelatives live under chronic stress for years, and many develop anxiety disorders, depression, sleep problems and high blood pressure. Your well-being matters in its own right, regardless of whether your loved one starts treatment.
MythSetting boundaries means abandoning the person
FactA boundary is not walking away; it is refusing to take part in destruction. You can say, “I love you and I’m ready to go to the doctor with you, but I won’t pay your debts anymore.” This keeps the relationship more honest than endless rescuing.
Prices: Codependency help
| Codependency help | 15 000 ₸ |
| Psychotherapist session (50 min) | 14 990 ₸ |
| Psychologist session (50 min) | 12 000 ₸ |
| Family session (80 min) | 25 000 ₸ |
| Phone consultation | free |
Prices are approximate: the doctor confirms the exact cost after the examination, before treatment starts.
Confidential
We do not register patients with state dispensaries or share information with employers. You do not have to give your surname; doctors arrive in unmarked cars. Medical confidentiality is protected by the Code of Kazakhstan “On Public Health and the Healthcare System”.
Clinic addresses
FAQ
Can I come if my loved one doesn’t admit there is a problem?
Yes, and this is the most common situation. Codependency support is for you, not for them, and does not require their consent or participation. Many relatives start working long before the person with the addiction agrees to treatment. Sometimes the changes in your behavior become the very factor that nudges them toward a doctor.
How is this different from treatment motivation and an intervention?
Motivation work and interventions focus on helping the person with the addiction decide to get treatment. Codependency work is about you: your health, your boundaries, your life. At Akalam, these services can be combined, but their goals differ, and the therapist will help you understand what you need right now.
How long does it take to feel better?
Many people notice they are sleeping better and feeling less anxious after 4–6 weeks of regular sessions. Lasting changes in habits of controlling and rescuing usually take 3–6 months. Your loved one may relapse during this time, and therapy helps you get through it without slipping back into old patterns.
I live in Talgar. Can I do sessions online?
Yes, the online format works for most sessions. It is important to find a place where you won’t be overheard: if the person with the addiction is at home, it is convenient to call from your car, from work or during a walk. You can also attend the relatives’ group online, although some people find it easier to open up in person.
Will my husband find out that I’m seeing a psychotherapist?
Only if you decide to tell him. The clinic does not contact relatives without your consent, and information about your visits is protected by medical confidentiality. If you are afraid he will see messages or notifications, discuss a convenient way to stay in touch with our administrator.
Do I need medication for anxiety?
Psychotherapists and psychologists do not prescribe medication. If anxiety, insomnia or low mood are severe and interfere with your life, the therapist will suggest a consultation with a psychiatrist. Only a doctor, after an assessment, decides whether medication such as antidepressants or anti-anxiety drugs is needed and selects it.
Sources and review
Prepared by the Akalam medical editorial team based on:
- ICD-10 and ICD-11: mental and behavioural disorders
- Clinical protocols of the Ministry of Health of Kazakhstan
- Code of Kazakhstan “On Public Health and the Healthcare System”
- WHO: mental health and substance use
- NICE and APA clinical guidelines
This information is for reference and does not replace a doctor's consultation. Editorial policy