Reviewed byTimur Abdrakhmanov, MDPsychotherapist · updated 11.11.2026
Key facts
- Who provides care
- an addiction physician and a psychotherapist trained in motivational interviewing; for the family, a separate consultation with a doctor or psychologist
- Where
- in person at the clinics in Almaty and Astana, at home during an addiction physician’s home visit, or online by video for any city in Kazakhstan
- Duration
- one session lasts 50–90 minutes; most often 1 to 5 consultations are needed, a few days apart
- Anonymity
- consultations are anonymous, with no registry entry; medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
- When it is urgent
- a threat to life, psychosis, aggression that endangers others or suicidal thoughts call not for motivation but for 103 or 112 right away
- Outcome
- the person’s consent to an examination, detox or rehab; a clear next step and an agreed date
What to know
Let me say honestly what relatives do not always want to hear: an adult cannot be made to get treatment — not by persuasion, not by threats, not by trickery. Under the law of the Republic of Kazakhstan, treatment is provided with informed consent, and involuntary treatment is possible only by a court decision in the established procedure. But between “forcing” and “doing nothing” there is a lot of room. Motivational work helps a person see for themselves what their drinking or drug use is costing them and take the first step.
Most people with addiction do not deny the problem entirely — they waver. Today they say “I have to quit,” tomorrow “everyone drinks like this.” This ambivalence is normal, and arguing with it is pointless: pressure usually strengthens resistance. At Akalam we use motivational interviewing, a method recommended by the WHO and NICE for substance use disorders. The specialist does not try to convince; instead, they ask questions in a way that lets the person hear their own reasons for change.
When Motivational Work Is Needed
- the person admits they drink or use a lot but keeps putting treatment off “until later”
- promises to quit are repeated, but after a few sober days everything starts again
- family conversations end in arguments, hurt feelings or silence
- the person agrees there is a problem but refuses any kind of treatment
- there has been an unsuccessful treatment experience, and now “nothing will help”
- fear of disclosure, of being put on a registry or of losing their job keeps them from seeking help
- relatives are exhausted and do not know which words won’t trigger resistance
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 a Person With Addiction Won’t Seek Treatment
Refusing treatment is rarely just stubbornness. For a long time, drinking or drug use served some function for the person: it relieved anxiety, helped them fall asleep, gave a sense of rest or of belonging to a group. Giving it up means losing a familiar way of coping without having another one. Add to that shame, fear of looking weak, and worry about disclosure and being put on a registry. When a person is pressured, they defend themselves, and that defense looks like denial.
The second reason is past experience. If there were IV drips and alcohol “coding” (aversion therapy widely used in Kazakhstan) followed by a relapse, the person concludes that treatment does not work and does not want to go through disappointment again. A motivational conversation helps separate an unsuccessful past experience from the future: to discuss what exactly did not work, what forms of help exist and what can be tried differently. It is important that the decision is their own — then it is more lasting.
How a Motivational Consultation Works
Often the family comes first: online or in person, the doctor listens to the story and explains how to talk to the person and how to suggest a meeting. Then comes a consultation with the person themselves — at our clinic, at home or by video. The specialist asks about their life rather than about “alcoholism,” helps them weigh what drinking or drug use gives and what it takes away, and clarifies fears and doubts. At the end, one specific step is discussed: an examination, lab tests, detox or a trial session with a psychotherapist.
A motivational conversation is not held with a person who is heavily intoxicated: talking is useless and sometimes dangerous. If there are signs of severe withdrawal, delirium tremens, psychosis, or a threat of harming oneself or others, what is needed is not motivation but emergency care — call 103 or 112. We do not come to “take someone away by force,” and we do not use covert administration of medication: it is illegal and destroys trust.
How we help
Motivational interviewing
This is a structured conversation in which the specialist asks open-ended questions, reflects back what was said and helps the person formulate their own reasons for change. The specialist does not argue or shame; instead, they notice and reinforce phrases like “I’m tired of living like this.” The method is described in international guidelines as effective for addiction and suits even people who come to the session with no desire for treatment.
Taking stages of readiness into account
The stages of change model helps understand where the person is: not yet thinking about treatment, wavering, preparing or already taking action. Each stage calls for different steps. For someone who is wavering, offering a month of rehab right away is pointless, but discussing lab tests or a meeting with a doctor is realistic. We choose the next step the person is ready to take right now.
Consultation for the family
We explain to relatives which phrases provoke defensiveness and which ones open up a conversation. We teach them to talk about their own feelings and concrete facts, without labels or threats, to choose a moment when the person is sober and to offer specific help. We discuss how to stop unknowingly enabling the drinking or drug use: paying off debts, covering for the person at work. The family often becomes the main source of motivation.
Information without intimidation
The doctor calmly and factually explains what is happening to the body, which tests are worth taking and what treatment options exist — from outpatient sessions to inpatient care. When a person sees that treatment is anonymous, involves no registry entry and does not necessarily mean long isolation, many fears go away. We do not frighten; we provide information for a well-considered decision.
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 person has to “hit rock bottom,” or treatment is useless
FactWaiting for a catastrophe is dangerous: before reaching “rock bottom,” there may be severe poisoning, an injury or job loss. Motivation can develop earlier, and the sooner a person starts treatment, the more of their health, relationships and resources they keep.
MythYou can slip medication into their food and they’ll quit
FactCovert administration of drugs is illegal and dangerous: combined with alcohol or other substances, it can cause severe reactions, and a person who discovers the deception stops trusting their family and doctors. Treatment is provided only with informed consent.
MythIf they refused once, there’s no point trying again
FactRefusal is a normal stage of ambivalence. Many people agree after several calm conversations, especially if the family has stopped pressuring and started talking differently. Motivational work is a process, not a single attempt.
Prices: Motivation for treatment
| Motivation for treatment | 25 000 ₸ |
| Residential rehab, per month | 299 000 ₸ |
| Outpatient program, per month | 120 000 ₸ |
| Consultation to choose a program | free |
| 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 book a motivational session without the person knowing?
A relative can make the booking, but the conversation itself takes place only with the person’s consent — otherwise it is not help but a trap, and trust will be lost. Start with a consultation for the family: the doctor will advise how to invite the person and explain why the meeting is needed without causing offense.
How many sessions are usually needed?
Sometimes one consultation is enough for the person to agree to an examination. More often, 2 to 5 sessions are needed, especially if there has been an unsuccessful treatment experience or a strong fear of disclosure. Between sessions, the family keeps working with its own specialist, which speeds up the process.
Do you hold the conversation at home?
Yes, an addiction physician can make a home visit in Almaty and Astana, and to other cities by arrangement. It is important that the person is sober or only mildly intoxicated and agrees to talk. If they are on a drinking binge, medical care is discussed first, and the motivational conversation is postponed to a day when they are able to take part in it.
What if the person is dangerous to themselves or the family?
If there is a threat of violence, suicidal thoughts, psychosis or severe intoxication with a risk to life, call 103 or 112. Motivational work is not used in such situations. Involuntary hospitalization is possible only by a court decision in accordance with the procedure established by the law of the Republic of Kazakhstan.
How is a motivational consultation different from an intervention?
A motivational consultation is a one-on-one conversation between the specialist and the person, in which they gradually arrive at a decision. A family intervention is a meeting prepared in advance, where loved ones, guided by a specialist, talk to the person together. Usually, motivational work comes first, and an intervention is planned if that is not enough.
Will the information be passed on anywhere?
No. Consultations are anonymous, with no registry entry, and everything said is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System.” We share with relatives only what the person has consented to. Exceptions are limited to cases expressly provided by law.
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