Reviewed byTimur Abdrakhmanov, MDPsychotherapist · updated 11.11.2026
Key facts
- Who provides it
- A psychotherapist trained in systemic family therapy; the clinic’s psychiatrist or addiction physician joins when needed
- Format
- In-person sessions at our office in Almaty, a blended format with relatives joining by video, and separate sessions with the couple or the teenager
- Duration
- Each session lasts 80–90 minutes; a course is usually 8–15 sessions held 1–2 weeks apart, while a brief consultation format takes 3–5 sessions
- Confidentiality
- Medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”; rules on what is discussed in front of everyone are agreed at the first session
- When it is urgent
- Threats, violence or suicidal thoughts in any family member come first as a safety issue: call 112 or 103; children and teenagers can call the 150 helpline
- Outcome
- Fewer repeated arguments, clear agreements about roles and boundaries, and the ability to talk about difficult things without shouting or silent treatment
What to know
Over my years of practice in Almaty, I have noticed that people rarely come to a family therapist saying “we are unhappy together.” More often, a mother from Bostandyk district calls to say her teenage son has stopped talking to anyone, or the wife of an IT specialist complains that since he switched to remote work, her husband lives inside his laptop. Family therapy begins when we stop looking for someone to blame and look at how communication actually works: who is allied with whom, who stays silent and who is always smoothing things over.
Families in Almaty are often multigenerational: grandparents, a young couple and children all under one roof in Nauryzbay district or in a private house in Alatau district. Decisions are made by everyone together, and responsibility gets blurred. That is why we invite to the first session the people who actually influence the situation, not just the one who is “suffering.” If a grandmother is not ready to drive across the city in traffic, we bring her in by video: hearing her voice matters more than making her travel.
When a Family Should Consider Therapy
- the same arguments keep repeating for weeks, and nobody remembers anymore how they started
- a teenager has withdrawn, won’t leave their room or only talks to their parents through a messaging app
- after a baby was born or the couple moved in with their parents, the partners stopped being on the same side
- someone in the family has an addiction or a mental disorder, and everyone’s life revolves around their condition
- decisions about money, children and grandparents are made with resentment and through third parties
- divorce is already on the table, but you want to understand whether the relationship can be saved or how to separate without a war
- family members have stopped talking about what really matters and only discuss chores, traffic and bills
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
Why Families Get Stuck
A family is a system that strives for balance, even when that balance is painful. When one person starts drinking, falls ill or pulls away, the others adjust without realizing it: one takes on everything, another protects, a third blames. Over time these roles become fixed and persist even after the original problem has been solved. That is why treating one person without working with the family often leads to the old patterns returning.
In Almaty, the pace of a big city adds to this: both partners work until evening, spend an hour or an hour and a half stuck in traffic on Al-Farabi or Sain, and come home with energy left only for chores. Moving in from the regions, sharing a home with parents, and different generational expectations about the role of a daughter-in-law, a son-in-law or the eldest son are all normal life circumstances. But without the skill of negotiating, they turn into chronic conflict instead of a reason to talk.
How Family Therapy Works
Before the first session, our administrator clarifies who will take part and offers a short call with the psychotherapist. At the first session, the therapist listens to each person, builds a genogram (a map of family relationships) together with the family and defines a shared goal. After that, joint sessions alternate with separate sessions for the couple or the teenager when needed. Between sessions, the family completes small assignments, such as 15 minutes of conversation without phones or a new rule for dividing household chores.
Family therapy is not suitable if one of the participants is in an acute state: a drinking binge, psychosis or severe depression with thoughts of death. In that case, help from an addiction physician or psychiatrist comes first, sometimes in an inpatient setting. In cases of domestic violence, joint sessions with the abuser are not safe: we work with the person who has been harmed separately and help them build a safety plan. If anyone’s life is at risk, call 112 or 103 right away; psychotherapy does not replace emergency services.
How we help
Systemic Family Therapy
The therapist views the problem as a feature of the whole system rather than of one person. Techniques include circular questions (“How does Dad know that Mom is anxious?”), the genogram and work on boundaries between generations. This approach is helpful when several generations live in one home and it is unclear who is responsible for what. The goal is not to find the guilty party but to help the family see its repeating cycles and break them.
Cognitive Behavioral Therapy for Couples
The couple learns to notice the automatic thoughts that trigger an argument: “he’s not listening to me again,” “she decides everything for me.” The therapist trains skills in active listening, making a request instead of a reproach, and step-by-step problem solving. The approach is structured, includes homework and suits busy people who want concrete tools rather than long conversations about childhood.
Work With Teenagers and Parents
Sessions are designed so the teenager does not feel “brought in to be fixed.” The therapist spends part of the session with them one-on-one, part with the parents and then everyone together. We discuss rules about devices, school, freedom and responsibility. If there are signs of depression, self-harm or substance use, we involve a child and adolescent psychiatrist and, if there is danger, explain when to call 150 or 112.
Family Therapy for Addiction
When a family member has an alcohol or other addiction, therapy helps the family agree on a common line: what they will support and what they will no longer cover up. It does not replace treatment with an addiction physician but continues it: after detox or rehab, old family roles often provoke relapse. We work on trust, control and how to talk about sobriety without interrogations.
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
MythThe family therapist will decide who is right
FactA therapist is not a judge and does not take sides. Their job is to help each person hear the other and find agreements that work for everyone. If someone feels the therapist is “on Mom’s side” or “on the husband’s side,” it is important to say so during the session.
MythIf you go to a psychotherapist, your marriage is already falling apart
FactMany couples come at a stage when the relationship is still valuable but communication has become hard: after a baby, a move or a job change. Seeking help early usually takes fewer sessions than trying to rescue a relationship that has been accumulating resentment for years.
MythTherapy is pointless without every family member
FactChange in a system begins even when only one or two people come. If a husband refuses, his wife can start on her own, and this will affect communication at home. Sometimes others join later once they see that the sessions don’t turn into blaming.
Prices: Family therapy
| Family therapy | 25 000 ₸ |
| 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
How many sessions does a family need?
Most often 8–15 sessions, once every one to two weeks. If the request is narrow, such as agreeing on rules for a teenager, 3–5 sessions may be enough. If the family has a long-standing conflict or an addiction, the work takes longer, sometimes with breaks. We discuss the number of sessions after the first meeting and review it as we go.
Can relatives from another city or from Kaskelen take part?
Yes, we use the blended format in Almaty all the time: part of the family sits in the office, while others join by video from Kaskelen, Talgar or another country. The person joining remotely needs a private room and a stable connection. For some emotionally intense sessions, it is better to meet in person.
What if my husband or teenager refuses to come?
There is no need to bring them by force or trickery: that undermines trust in therapy. Start on your own and discuss with the therapist how to invite the person who is refusing. An invitation to come just once “to tell your side of the story” often helps. An adult cannot be forced into treatment, but you can change how the family interacts with them.
How is family therapy different from help with codependency?
Family therapy works with the whole system and shared agreements. Codependency support focuses on one person, the relative of someone with an addiction, and on their boundaries, guilt and their own life. Sometimes these formats run in parallel, and a Akalam therapist will suggest where to start.
What times are sessions held?
The most requested times in Almaty are weekday evenings and weekends, because parents work and crossing the city at rush hour can take up to an hour. We try to schedule family sessions after 6:00 p.m. and on Saturdays. If someone finds it hard to travel, some sessions can be held online.
Will the therapist tell other family members what I said in private?
Confidentiality rules are agreed at the first session. Usually the therapist does not share what was said in private without your consent, but may offer to help you raise the topic yourself. The exception is a threat to life, such as a risk of suicide or violence against a child: in that case, safety comes first.
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