Reviewed byKsenia Voronova, MDPsychotherapist · updated 11.11.2026
Key facts
- Who provides care
- a psychotherapist experienced in addiction treatment, working together with an addiction physician and, when needed, a psychiatrist
- Format
- individual sessions in person in Almaty and Astana or online; joint sessions with a family member when indicated
- Duration
- sessions last 50–60 minutes; the intensive stage is 1–2 sessions a week for 2–3 months, followed by maintenance sessions for up to a year
- 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 dispensary registry
- When it is urgent
- a drinking binge with tremors and hallucinations, seizures, an overdose, suicidal thoughts — call 103 or 112 immediately; this is not a job for psychotherapy
- Outcome
- an understanding of your triggers, skills to cope with cravings, a relapse prevention plan and more stable sobriety
What to know
I often see the same picture: a person has gone through detox, feels well and is sure they can now manage on their own. A few weeks later, stress, a conflict or simply boredom comes along — and they relapse. It is not a matter of weak willpower. Detox removes the consequences of drinking or drug use, but it does not change the reasons why the person drank or used: to relieve tension, numb anxiety, fall asleep or feel more confident. That is exactly what addiction psychotherapy works with.
This page is specifically about the psychotherapy part of treatment, which begins after the acute state has been treated and runs in parallel with follow-up by an addiction physician. We do not cover detox, alcohol “coding” (a treatment widely used in Kazakhstan and CIS countries) or rehab programs here — there are separate pages about them. This is about regular sessions with a psychotherapist, in which a person learns to understand their addiction, cope with cravings and build a life in which the substance or gambling takes up less and less space.
When addiction psychotherapy is needed
- strong cravings and thoughts about using remain after detox or “coding”
- relapses keep happening despite a sincere wish to quit
- alcohol, a substance or gambling is your main way of relieving stress and anxiety
- it is hard to say no in company, at celebrations or after conflicts
- the addiction comes together with depression, anxiety or insomnia
- you want not just to “stop drinking” but to understand why this happens
- family relationships have broken down and you want to rebuild them
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
What keeps addiction going and why sobriety alone is not enough
Addiction in ICD-10 (codes F10–F19, gambling disorder F63.0) is not just a physical dependence. Over time, a substance or gambling becomes the main way of regulating emotions: coping with anxiety, boredom, loneliness and fatigue. The brain remembers the link between certain situations and relief, and those situations start to trigger cravings automatically. Even after a long period of sobriety, encountering them can cause a strong urge to use.
That is why restrictions alone are not enough: if a person has not learned other ways of dealing with stress, the void left by the old behavior quickly fills up again. Other difficulties often lie beneath an addiction — depression, an anxiety disorder, the after-effects of trauma, relationship problems. Psychotherapy helps uncover and treat them, and if medication support is needed, a psychiatrist from our team joins in.
How addiction psychotherapy works at Akalam
The work begins once the acute state has been treated and the person has been sober for at least a few days — the addiction physician confirms readiness. At the first session, the psychotherapist asks without judgment about the history of use, what it gives the person and what it costs them, and assesses motivation. Then you map out your triggers together and draw up a plan. After that come regular sessions where skills are practiced. The online format is suitable for the maintenance stage and for people living in other cities of Kazakhstan.
Psychotherapy is not carried out while a person is intoxicated or going through severe withdrawal — they first need help from an addiction physician. If a binge is accompanied by tremors, hallucinations, seizures, chest pain or vomiting blood, if there are signs of an overdose or suicidal thoughts, call 103 or 112. In severe addiction with frequent relapses, the doctor may recommend inpatient treatment or a rehab program.
How we help
Motivational interviewing
This method helps a person sort through their own mixed feelings: “I want to quit, but I can’t cope without it.” The psychotherapist does not persuade or argue, but helps the person hear their own reasons for change. WHO and NICE guidelines list motivational interviewing among the effective approaches to addiction, especially in the early stages, when the decision has not yet become firm.
Cognitive behavioral therapy for addiction
In CBT, a person examines their own “situation — thought — craving — use” chains and learns to break them at different points. They practice refusal skills, ways to ride out a wave of craving, planning evenings and weekends, and solving problems without the substance. Assignments between sessions help carry these skills into real life.
Relapse prevention
A relapse is not a disaster and not proof that everything is pointless; it is a signal that the plan needs refining. Together with the psychotherapist, the person identifies high-risk situations, early signs of an approaching relapse and a clear course of action if one does happen: whom to call, how to stop and how to get back to treatment.
Working with emotions and co-occurring conditions
Many people use substances to cope with anxiety, anger, shame or insomnia. The psychotherapist helps them learn to tolerate these feelings and express them in other ways. If depression, an anxiety disorder or the after-effects of trauma are identified, they are treated at the same time as the addiction — as international guidelines recommend.
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 you’ve had “coding,” you don’t need psychotherapy
Fact“Coding” and medication support can help a person stay sober at the start, but they do not teach how to live without the substance. Psychotherapy complements them and helps build lasting skills by the time the restrictions wear off.
MythPsychotherapy only works if the person “wants it themselves”
FactMotivation is rarely complete from the very start. Motivational interviewing is designed precisely to help it grow: many people begin therapy with doubts, and the decision matures along the way. The main thing is agreeing to come to at least one session.
MythOne relapse and all the treatment is wasted
FactRelapses on the road to sobriety are common and do not erase the progress made. What matters is getting back to treatment quickly and working out what led to the relapse. This makes the prevention plan more precise and lowers the risk of further relapses.
Prices: Addiction psychotherapy
| Addiction psychotherapy | 18 000 ₸ |
| 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
When can psychotherapy start after a drinking binge?
As a rule, after a few days of sobriety, once the severe withdrawal symptoms have passed and the person can focus on a conversation. The exact timing is decided by the addiction physician. The first session is sometimes held while the person is still in hospital, so that right after discharge they have a plan and a specialist they can turn to.
How is psychotherapy different from a rehab center?
A rehab center means a long stay in a program with a set routine and group work. Addiction psychotherapy means regular sessions with a specialist while you carry on your usual life at home, at work and with your family. It suits people who have enough resources to stay sober in their usual environment, and it also works as a continuation after rehab.
Can psychotherapy be done online?
Yes, especially at the maintenance stage and if you live in a city where we do not have a clinic. It is important that you are sober during sessions and in a private place. At the start of treatment and with frequent relapses, in-person sessions in Almaty or Astana together with follow-up by an addiction physician are preferable.
Will my employer or local clinic find out?
No. At Akalam, treatment is provided anonymously, on a paid basis, without entry in the state dispensary registry. The information is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System” and is disclosed only in cases expressly provided for by law.
Does psychotherapy help with gambling addiction?
Yes — for gambling addiction, psychotherapy is the main treatment method, as there are no specific medications for it. CBT, motivational interviewing and work on financial limits and triggers are used. Depression and anxiety, which often accompany gambling addiction, are frequently treated at the same time.
Does the family need to be involved?
It is not required, but it is often helpful. With the patient’s consent, one or two joint sessions can be held to agree on support and house rules. If relatives need help themselves, there is separate work on codependency and family therapy for that.
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