Reviewed by: Madina Abdrakhmanova, addiction psychologist · updated 6 Nov 2026
Key facts
- Who provides care
- a psychotherapist or clinical psychologist trained in couples and family therapy
- Format
- joint video sessions; separate sessions with each partner if needed
- Duration
- 60–80-minute sessions, usually weekly or every two weeks; a course of 8–20 sessions
- Confidentiality
- confidential, no registration; rules for sharing information are discussed at the first session
- When it's an emergency
- physical violence, threats, suicidal thoughts — call 102, 103, 112 or 150
- Outcome
- calm discussion of difficult topics, rebuilt trust or a conscious decision about the couple's future
What you should know
Couples come to us with very different words: “we've stopped talking,” “everything changed after the baby was born,” “I found out about an affair and don't know how to go on.” Getting help with us is simple: one of the partners messages us on WhatsApp, the administrator checks whether both are ready to take part and offers an evening time. At the first video session, the specialist gets to know the couple, asks about the history of the relationship and what each person would like to change, and agrees on ground rules — speak about yourself, no insults.
In Almaty, couples often have very little free time together: one works downtown on Dostyk Avenue, the other gets home from Alatau district at eight in the evening, and then there are the children, relatives and endless traffic. An online session removes some of those obstacles — no need to find a babysitter and drive to an appointment; all you need is a laptop and a closed door. Psychiatry Online works with married and unmarried couples, with young couples and those who have been together for decades, as well as with partners who are deciding whether to stay together.
When a Couple Should See a Psychotherapist
- arguments flare up over small things and end with days of resentment
- you've stopped talking about what matters and live like roommates
- there has been infidelity or another event that has undermined trust
- the birth of a child, a move or a job loss has dramatically changed the relationship
- there are disagreements about money, children or relatives that you can't resolve
- intimacy has declined, and talking about it feels awkward or frightening
- you are thinking about breaking up but want to understand what's going on first
If at least two points apply and the state lasts longer than two weeks, it is worth seeing a specialist. Phone consultation is free. If life is at risk, call 112 or 103.
Why Couples End Up in Crisis
Almost every couple goes through periods of tension, and most often these are linked not to the “wrong” partner but to repeating cycles of interaction. One partner pushes for a conversation, the other withdraws; one criticizes, the other gets defensive. The more often such a cycle repeats, the more resentment builds up and the less sense of safety remains. External pressures — work, finances, illness, interference from relatives — make the crisis worse.
Relationship research shows that what matters for a lasting relationship is not the absence of conflict but the ability to recover from it, show respect and maintain an emotional connection. Couples therapy, including emotionally focused and integrative behavioral approaches, helps partners see their cycle from the outside, understand the needs behind it and learn to talk about those needs in a new way.
How Couples Therapy by Video Works
Partners can sit side by side in front of one screen or join from different places — for example, if one of them is on a business trip. It is important that children and other people are not nearby. The specialist helps each partner talk about their feelings rather than blame, slows the conversation down when tension rises, and suggests exercises for the week: for example, a daily 15-minute conversation without phones, or expressing gratitude for specific actions.
Joint therapy is not carried out if there is physical violence, threats or strong control by one partner over the other — in that case safety comes first; if you are threatened, call 102 or 112, and help is provided individually. If one partner has an active addiction, severe depression or suicidal thoughts, treatment with a narcologist or psychiatrist is needed first; if there is a threat to life, call 103, 112 or 150.
How we help
Emotionally focused therapy
This approach helps partners recognize the negative cycle they are stuck in and see the fear of loss, loneliness and need for closeness behind the reproaches and withdrawal. When these feelings are expressed openly, partners begin to respond to each other differently. The method is well researched and is used in an online format.
Communication skills training
The specialist teaches the couple to talk about difficult things without blame, to listen without interrupting and to make requests instead of complaints. Partners practice these skills in sessions on real topics — money, household chores, relatives — and then try using them at home. Gradually, arguments become shorter and more productive. This is the foundation for the rest of the work.
Working through infidelity and rebuilding trust
After infidelity, a couple needs to go through several stages: cope with the acute pain, understand what led to the situation and decide whether there is a basis for rebuilding the relationship. The specialist helps both partners speak their minds and make a conscious decision. Rebuilding trust is a long process, but many couples succeed.
Counseling when deciding whether to separate
Sometimes a couple comes to figure out whether it is worth continuing the relationship. The specialist does not push toward either staying together or breaking up but helps each person clarify their feelings and expectations. If the decision is to separate, it is important to do so with as little harm as possible to both partners and to the children. The specialist supports both partners along the way.
Myths and facts
MythIf you need therapy, the relationship is already doomed
FactMany couples seek help during a crisis and come out of it with a stronger bond. The earlier you start, the better the chance that accumulated resentments won't become insurmountable. You can reach out at any point.
MythThe psychotherapist will decide which of us is right
FactThe specialist is not a judge. Their job is to help both partners understand each other and find solutions that work for the couple. In couples therapy, the “client” is the relationship itself, not one of the partners.
MythIt's uncomfortable to talk about personal things online
FactFor many couples, online is actually easier: they are at home, in familiar surroundings, with no travel and no waiting room. Confidentiality is maintained, and the conversation is not recorded. Many choose this format for exactly that reason.
How an online appointment works
- Message or callWrite on WhatsApp or call — our coordinator replies within minutes, day or night. You don't have to give your surname.
- Doctor and timeWe match you with a psychiatrist, addiction specialist or psychotherapist and agree on a time — often the same day.
- Video consultationA secure 50–60 minute video call: the doctor takes a detailed history and uses standardised scales if needed.
- Treatment planYou receive a clear summary, recommendations and a plan: what we do online and what needs an in-person visit or home call.
- Follow-upOnline follow-up sessions, messenger contact with your doctor, and treatment adjustments until you get a stable result.
Prices in Almaty
| Online therapy session (50 min) | 15 000 ₸ |
| Package of 8 online sessions | 110 000 ₸ |
| Family/couples session (80 min) | 20 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
Psychiatry Online in Almaty: same-day video appointments and two branches for in-person visits — 129 Kurmangazy St., office 8, Almaty and 110 Bogenbay batyra St., office 15, Almaty. Our mobile team works around the clock: all city districts and nearby settlements. If you live elsewhere in Almaty and Almaty Region, starting online is usually easiest.
Confidential and private
An online appointment in Almaty is first of all about privacy: no clinic visit, no waiting room. A private room and headphones are enough. Data is stored in a secure system with restricted access and does not enter any state registry without legal grounds.
Questions and answers
What if my partner doesn't want to go to therapy?
You can start with an individual consultation: the specialist will help you sort through your feelings and think about how to invite your partner. Sometimes changes in one person's behavior shift the couple's dynamic. Later on, the other partner often joins the sessions on their own.
How many sessions does a couple need?
It depends on your goals. Working on communication skills may take 8–12 sessions, while recovering from infidelity or a long-standing crisis takes longer. After the first few sessions, the specialist will discuss an approximate plan and regularly check with you whether things are moving forward.
Can we do couples therapy if we live apart?
Yes. The online format lets you join from different places — for example, one partner in Almaty and the other on a business trip or staying with parents in Talgar. All that matters is that each of you has a stable connection and can talk without others present.
Do you hold sessions with each partner separately?
Sometimes, if it helps the work. Confidentiality rules are discussed in advance: the specialist does not keep one partner's secrets from the other if they are important for the joint work. This helps maintain both partners' trust in the process.
Is couples therapy appropriate if one of us drinks?
Couples therapy can be part of the help, but with significant dependence, treatment with a narcologist comes first. Psychiatry Online offers online consultations with a narcologist and a psychotherapist, and the specialists coordinate the plan so that work on the relationship and on the addiction can run in parallel.
Is it convenient to have a session in the evening after work?
Yes, we offer evening times and weekends. Many couples in Almaty choose late sessions when the children are already asleep and there's nowhere to drive. The only important thing is that neither of you is too tired for a serious conversation. We schedule the time in advance.
Where can I be seen in Almaty?
Online — from anywhere in the city or region. In person — at two branches: 129 Kurmangazy St., office 8, Almaty and 110 Bogenbay batyra St., office 15, Almaty. Both are open 24/7; home visits cover all city districts and nearby settlements.
Sources and methodology
This page was prepared by the Psychiatry Online medical editorial team based on:
- International Classification of Diseases ICD-10 and ICD-11, World Health Organization
- Clinical diagnosis and treatment protocols of the Ministry of Health of the Republic of Kazakhstan
- Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
- NICE (UK) and APA (US) guidelines on the treatment of mental disorders
- WHO recommendations on telemedicine and digital health
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
