Reviewed byTimur Abdrakhmanov, MDPsychotherapist · updated 11.11.2026
Key facts
- Who provides it
- A psychotherapist or clinical psychologist trained in systemic family therapy; a psychiatrist joins when needed
- Format
- Joint family sessions, plus separate sessions with the couple or the teenager; in person in Almaty and Astana or online
- Duration
- Sessions last 60–90 minutes, once every 1–2 weeks; a course is usually 8 to 20 sessions, sometimes shorter
- Confidentiality
- Medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”; no registration with the state dispensary
- When it is urgent
- Domestic violence, threats, or suicidal thoughts in any family member: call 112; for children and teenagers, call the 150 helpline
- Outcome
- Fewer acute conflicts, clear agreements, and the ability to discuss difficult things without damaging relationships
What to know
Families often come to me saying, “We can’t talk to each other anymore without shouting,” or “Our son has stopped speaking to us, and we don’t understand why.” Family therapy is needed precisely when the problem lives not inside one person but between people. The therapist’s job is not to find someone to blame or to take sides, but to help each person hear the others and see the repeating cycle the family has become stuck in. It is calm, structured work, not a session for airing grievances.
It is important to understand how family therapy differs from related formats. An individual consultation with a psychotherapist helps one person make sense of themselves. Codependency work is support for the relatives of someone with an addiction. Family therapy involves the whole family: spouses, parents and teenagers, and sometimes grandparents. It is appropriate during a divorce, after the birth of a child, during illness, a move, or the loss of a loved one, and after one family member has completed treatment.
When a Family Should See a Family Therapist
- the same arguments repeat for months and end in silence or shouting
- you have lost contact with your teenager: withdrawal, defiance, running away from home
- the couple’s relationship deteriorated sharply after a baby was born or after a move
- the family is going through a loss, a serious illness, or the disability of a loved one
- a family member has come home after addiction treatment, and everyone is struggling to adjust
- the spouses are discussing divorce and want to go through it without harming the children
- a child has become the “lightning rod”: the adults take out their frustration on them, and their schoolwork and sleep have suffered
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 Long-Term Difficulties Develop in Families
Every family lives by unwritten rules: who makes decisions, what is never talked about, how anger and affection are expressed. While life is stable, these rules work. But at times of change, such as the birth of a child, a teenager growing up, illness, or job loss, the old rules no longer fit and new ones have not yet formed. People keep acting the way they always have, get the reaction they always get, and the conflict repeats itself. In the systemic approach, this is called an interaction cycle, and it can be recognized and changed.
The second common reason is unspoken pain. Resentment, losses, the difficult experiences of previous generations, and a loved one’s addiction or mental illness are rarely discussed openly, yet they affect everyone. Children often take on adult roles: comforting a parent or acting as a go-between. None of these situations means the family is “bad.” It has simply run out of ways to cope and needs outside help.
How Family Therapy Works: From the First Call to the Final Session
First, one family member calls or messages our administrator, and we briefly clarify the request and who is in the family. The first session lasts 90 minutes and includes everyone who is willing to come: the therapist gets to know each person, explains the ground rules (we take turns speaking, no insults, and what is said stays in the room), and works with the family to define a goal. After that, joint sessions alternate with separate ones for the couple or the teenager. Small tasks are given between sessions. Online sessions work well when family members live in different cities.
Family therapy is not appropriate while physical violence is still happening in the family. In that case, the first priority is the safety of those affected, a report to the police (102), and crisis support, and joint sessions are postponed. If any participant has acute psychosis, severe depression with thoughts of death, or ongoing substance use, they first need an assessment by a psychiatrist or an addiction physician. If anyone’s life is in danger, call 103 or 112.
How we help
Systemic family therapy
This is the core approach in our work. The therapist looks not at the “problem” family member but at how the relationships are structured: who is allied with whom, who is distant, and how responsibility is shared. Using circular questions, a genogram (a family map spanning several generations), and discussion of recurring situations, the family begins to see its cycles from the outside and tries out new ways of responding.
Couples therapy
Sessions with just the two partners, when the difficulties mainly concern the couple’s relationship: jealousy, emotional distance, infidelity, or constant arguments about money or parenting. We work on how partners express their needs and hurts, and practice having difficult conversations that end in an agreement. The therapist does not decide whether the marriage should continue; that choice belongs to the couple.
Work with teenagers and parents
Teenagers often refuse to talk in front of their parents, and parents in front of the teenager. So we alternate: a separate session with the teenager, a separate one with the parents, and then a joint one. The teenager knows that what they say will not be passed on without their consent, except when someone’s life is at risk. The goal is to restore contact and agree on rules that both sides consider fair.
Psychoeducation for the family
When a family member has depression, bipolar disorder, schizophrenia, dementia, or an addiction, relatives need to understand what is happening. The psychotherapist explains how the illness shows itself, what helps and what makes symptoms worse, and how to share caregiving so that no one burns out. This approach is part of NICE guidance on supporting families affected by severe mental illness.
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
MythA family therapist will decide who is right
FactA therapist is not a judge and does not take sides. Their job is to make sure everyone is heard and to help the family find a solution that works for all of them. If someone expects the specialist to “explain” to their spouse or child that they are wrong, we discuss that expectation honestly in the first session.
MythIf one person refuses, therapy is impossible
FactYou can start with those who are ready. Changes in one family member’s behavior inevitably affect the others, and those who refused often join later, once they see that no one is blamed in the sessions. Sometimes the work continues with only part of the family, and that still produces results.
MythPeople only see a family psychologist right before a divorce
FactMost families who come to us want to keep their relationships intact and get through a difficult period: a new baby, an illness, adolescence, or a loss. The earlier a family seeks help, the less resentment has built up and the shorter the course usually is.
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 will we need?
It depends on the request. If you need to reach an agreement on one specific issue, 4–6 sessions are sometimes enough. With long-standing conflicts, a loss, or illness in the family, a course usually takes 10–20 sessions, and the gaps between them grow longer over time. We discuss the timeline at the first session and review it as the work progresses.
Can we bring our children?
Yes. Children of primary school age are usually invited to some of the sessions so the therapist can see how they fit into the family, without burdening them with adult conversations. Teenagers are seen both together with their parents and on their own. Topics that concern only the spouses are discussed without the children.
What if someone in the family has an addiction?
Family therapy helps, but it does not replace treatment of the addiction itself. If the person is still using, the first step is a consultation with an addiction physician. In parallel, codependency work can help the relatives. After treatment, family sessions help rebuild life together without the old roles and mistrust.
Is family therapy available online?
Yes, as long as all participants can join from a quiet place where outsiders cannot overhear them. Online sessions are convenient when family members live in different cities in Kazakhstan or abroad. You can combine formats: some sessions in person in Almaty or Astana and some by video. We usually recommend holding the difficult first sessions in person.
Will the therapist tell one person what another said?
No. Before individual sessions, we agree in advance on what may be brought into the joint session. The therapist does not keep secrets that undermine the work, such as a hidden affair, indefinitely, and helps the person decide how to deal with it. The exception is any threat to someone’s life or health.
Who should come to the first session?
Ideally, everyone affected by the problem who is willing to come. If only one person is ready for now, that is fine: the first session can be held with them to understand the situation and think through together how to invite the others. At Akalam, our administrator will help you choose a convenient time and format.
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