Reviewed byAigul Serikova, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F42
- Who provides care
- a psychiatrist (diagnosis, medication) and a psychotherapist trained in CBT with exposure and response prevention (ERP)
- Format
- in person at our clinics in Almaty and Astana or online by video; exposure exercises are often done at home between sessions
- Duration
- appointments last 50–60 minutes; a CBT course is usually 12–20 weekly sessions; if medication is prescribed, its effect is assessed after 8–12 weeks
- Confidentiality
- medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System,” anonymous care, no entry in the state registry
- When it is urgent
- suicidal thoughts, refusing food and water out of fear of contamination, being completely unable to stop the rituals — call 103 or 112
- Outcome
- rituals take up less time, the anxiety caused by intrusive thoughts weakens, and the person gets back their time, work and relationships
What to know
People with OCD often avoid seeing a doctor for years: they are ashamed to talk about their thoughts and afraid of being seen as dangerous or “crazy.” So I start with the most important point: in OCD, intrusive thoughts are not what a person wants — they are exactly what horrifies them most. Someone who keeps having intrusive thoughts about harming a child is, as a rule, more afraid than anyone in the world of actually doing it. A doctor has heard things like this many times, and it does not shock them.
OCD in ICD-10 (F42) and ICD-11 (6B20) is a combination of obsessions (recurring, frightening thoughts, images or urges) and compulsions (actions or mental rituals that temporarily relieve anxiety). The trouble is that the relief is short-lived, and the rituals grow over time: handwashing, checking, counting and rearranging things can take hours. Treatment aims to break this cycle, not to make a person “never think about anything frightening again.”
Signs that it might be OCD
- recurring thoughts or images that are frightening and feel alien, yet will not go away
- washing hands, cleaning or doing laundry again and again out of fear of dirt or contamination
- checking the door, stove or iron many times, going back home just to check
- a need to arrange things symmetrically, count, or repeat actions “until it feels right”
- mental rituals: prayers or repeated phrases that “cancel out” a bad thought
- avoiding places, objects and people that trigger intrusive thoughts
- rituals take up more than an hour a day and interfere with work, study and relationships
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 OCD develops and what keeps it going
OCD has a biological basis: research links it to the activity of specific neural circuits in the brain and to an inherited predisposition. The disorder often begins in adolescence or young adulthood, sometimes after stress, the birth of a child or an illness. Importantly, OCD is not a personality trait and not “just being neat.” A tidy person enjoys order, whereas a person with OCD suffers because they cannot stop.
OCD is maintained by the very mechanism of the rituals. A thought causes anxiety, a ritual reduces it, and the brain remembers: “the ritual saved me.” Next time, the anxiety is stronger and more rituals are needed. Avoidance and endless requests for loved ones to confirm that “everything is fine” work the same way. When relatives answer these questions out of love, they unintentionally reinforce the disorder, which is why we teach them as part of treatment, too.
How OCD treatment works at Akalam
The first session is diagnostic: the psychiatrist asks in detail about the thoughts and rituals, uses the Y-BOCS scale to assess severity and rules out depression, tics and other disorders. Then we draw up a plan: CBT, medication or a combination of both. In sessions, the psychotherapist builds a “ladder” of situations with you, from easy to difficult, and gradually — with your agreement — you practice facing them without rituals. Much of the work can be done online, which is especially convenient because the exercises take place right at home.
The online format is not suitable if obsessions are combined with severe depression and suicidal thoughts, with refusal of food and water out of fear of contamination, or if the person has completely lost the ability to break out of rituals and take care of themselves. In these cases, an in-person psychiatric assessment and sometimes hospital care are needed. If you have suicidal thoughts, call 112 immediately; children and young people can also call the 150 helpline.
How we help
CBT with exposure and response prevention
According to NICE guidelines, this is the main psychotherapy method for OCD. The person gradually and voluntarily faces what makes them anxious and learns not to perform the ritual. The anxiety rises at first and then falls on its own — and the brain gains a new experience: “nothing terrible happened.” Exercises progress from simple to difficult, and the pace is always agreed with the patient.
Medication
For moderate and severe OCD, a psychiatrist may prescribe antidepressants from specific classes that have proven effective for obsessions. The effect builds gradually, usually over several weeks, and is assessed after 8–12 weeks. If the response is insufficient, the doctor sometimes adds medications from other classes. All prescriptions are made only after an assessment, with regular monitoring.
Working with the family
We explain to relatives how taking part in rituals and constantly giving reassurance keeps OCD going. Together, we agree on how to reduce this involvement gradually and gently, without hurting the loved one. This is especially important for OCD in teenagers, where the family is a full participant in therapy and helps with exercises between sessions.
Relapse prevention
After improvement, we draw up a plan for the future: which situations might bring the obsessions back, how to spot the first signs and which exercises to repeat on your own. OCD tends to return under stress, so the skills gained in therapy stay with the person as a personal toolkit. If medication has been prescribed, it is stopped gradually and only with a doctor.
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
MythOCD is just a love of order
FactPerfectionism and neatness bring pleasure. OCD brings suffering: the person understands that the rituals are excessive but cannot stop, because otherwise the anxiety becomes unbearable. It is a disorder, not a personality trait.
MythIf I think something terrible, it means I could do it
FactIntrusive thoughts in OCD go against a person’s values, and that is precisely why they cause horror. Having such thoughts does not make a person dangerous. A psychotherapist helps change how you relate to the thoughts rather than fighting them.
MythOCD cannot be treated
FactWith CBT with exposure and, when needed, medication, most patients see a marked reduction in symptoms. A complete disappearance of the thoughts is usually not promised, but the person stops letting them run their life.
Prices: OCD treatment
| OCD treatment | 20 000 ₸ |
| Psychiatrist consultation at the clinic | 15 990 ₸ |
| Psychiatrist home visit | 35 000 ₸ |
| Follow-up visit, treatment adjustment | 12 000 ₸ |
| 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 is a psychiatrist different from a psychotherapist in OCD treatment?
A psychiatrist makes the diagnosis, assesses severity, rules out other disorders and prescribes medication when needed. A psychotherapist delivers CBT with exposure. For mild OCD, psychotherapy may be enough; for moderate and severe OCD, a combination is usually more effective. Often the two specialists work as a team.
Will exposure be frightening?
There will be some anxiety — the method does not work without it. But no one forces you: each exercise is chosen together, and we start with what you rate as manageable. The psychotherapist explains why it is needed and supports you. Most patients say that anticipating the exercise was harder than the exercise itself.
Can OCD be treated online?
Yes, research shows that CBT for OCD delivered by video can be effective. Online sessions are even more convenient for practicing home-related exercises: checking, cleaning, arranging things. An initial in-person psychiatric consultation is preferable if medication is to be prescribed, but many patients from other cities in Kazakhstan start directly with an online appointment.
How long should medication be taken?
Usually, once the effect is achieved, treatment continues for at least a year to reduce the risk of symptoms returning. Only a psychiatrist decides when to reduce the dose and stop, and it is done gradually with monitoring. If CBT is carried out at the same time, stopping is easier to tolerate.
Will anyone find out that I sought help?
No. Akalam maintains medical confidentiality, and you can receive care anonymously, without being placed on a registry. You decide yourself whether to tell relatives or your employer about the treatment. Information is disclosed only in cases expressly provided for by the law of the Republic of Kazakhstan.
How can I help a loved one with OCD?
Do not argue with or mock the rituals, but do not take part in them either: do not re-check things for the person and do not answer the same question endlessly. Do this gently, ideally as agreed with the psychotherapist. Offer to go to a consultation together, and in the meantime, book a session for the family.
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