Reviewed by: Askar Sarsenbayev, MD, addiction medicine physician · updated 6 Nov 2026
Key facts
- Who provides care
- A psychotherapist, a clinical psychologist and an addiction specialist on request
- Format
- Individual or family online sessions
- Duration
- Sessions of 50–60 minutes, a course of 6–8 sessions or more
- Anonymity
- Confidential; you don’t have to give your name at the first appointment
- When it’s urgent
- Threat of violence, a loved one’s overdose, suicidal thoughts — call 103 or 112
- Outcome
- Less anxiety, a clear strategy and steps toward your loved one’s treatment
What you should know
Codependency is not a separate diagnosis in ICD-10 or ICD-11, but it is a pattern well described in clinical practice. A relative’s life gradually begins to revolve around the person with the addiction: constant control, attempts to rescue, hide and fix the consequences, followed by outbursts of anger and exhaustion. Research shows that family members of people with addiction are more likely to suffer from anxiety, depression, insomnia and stress-related physical complaints — they need help themselves.
The online format is especially convenient for relatives: they often cannot leave the home where the person with the addiction lives for long, or they feel embarrassed to come to a clinic. At Psychiatry Online, a consultation can be held from your car outside the office or from another room with headphones. For families where one spouse works late on the left bank and the other is busy with the children, an evening video call is a real chance to get support without spending time driving through the winter city.
Signs of Codependency in a Family Member
- your mood depends entirely on whether your loved one is sober today
- you hide the problem from friends, colleagues and other relatives
- you regularly pay off their debts, call their work and make excuses for them
- constant control: checking their phone and pockets, searching for hidden stashes
- your own interests, health and rest have taken a back seat
- guilt and shame alternate with outbursts of anger and despair
- you have developed insomnia, anxiety, headaches or frequent colds
If heavy drinking has lasted more than two or three days, or there is shaking, vomiting, blood-pressure spikes or insomnia, you need a doctor rather than stopping alone. An online consultation is free and helps assess the risks before a visit. For seizures, confusion or hallucinations call 103 or 112.
Why Codependency Develops: The Family System
A family is a system in which a change in one member changes the behavior of the others. When someone starts misusing substances, loved ones adapt: they take on responsibilities, smooth over conflicts and protect the children. In the short term this helps, but in the long run it shields the person from the consequences of their behavior — research calls this enabling behavior, which unintentionally sustains substance use.
The chronic stress of living with someone with an addiction triggers the same reactions as any long-term threat: hypervigilance, disrupted sleep and emotional exhaustion. Codependent people have often grown up in families where there was also addiction and learned the role of the rescuer. Isolation makes the problem worse: a long winter, when the family spends almost all its time in the apartment, can make the tension especially palpable.
How an Online Consultation for Family Members Works
At the first session, the specialist clarifies the situation: who is using, for how long, what you have already tried, whether there are children in the family and whether there is a risk of violence. Your own symptoms are discussed: sleep, anxiety and mood. Join from a place where the person with the addiction cannot hear you — your car, an office, a room with headphones. A plan is then drawn up: working on your own well-being, learning communication skills and preparing for a conversation about treatment. Joint sessions with several relatives are possible.
Emergency care for the person with the addiction cannot be provided online. If your loved one shows signs of an overdose, psychosis or a severe drinking binge, or there is a threat of violence, call 103 or 112. If your own condition is severe — marked depression, panic attacks or thoughts of suicide — an in-person examination by a psychiatrist may be needed.
How we help
The CRAFT Approach
Community Reinforcement and Family Training (CRAFT) is a method for training relatives, designed to motivate a person with an addiction to seek treatment without confrontation. The relative learns to reinforce sober behavior, allow natural consequences to happen and choose the right moment to offer help. Research shows this approach leads loved ones into treatment more often than harsh interventions.
Cognitive Behavioral Therapy
CBT helps the relative notice automatic thoughts such as “it’s my fault” or “if I let go of control, something terrible will happen,” and test how realistic they are. Skills for reducing anxiety, restoring sleep and planning one’s own life are practiced. Homework is conveniently discussed by video once a week, in a calm setting.
Psychoeducation About Addiction
Understanding that addiction is a disorder with biological mechanisms, not just a weakness of character, reduces guilt and anger. The specialist explains how cravings work, why relapses happen, and what the family realistically can and cannot do. This makes expectations more realistic and reduces disappointment.
Boundaries and Safety
An important part of the work is learning to set boundaries: what you are and are not willing to do, how to respond to a relapse, and how to protect the children and finances. If there is a risk of violence, a safety plan is drawn up. The specialist helps phrase these rules so that they can be maintained consistently and without guilt.
Myths and facts
MythIf you love and control them enough, they will quit
FactControl and rescuing often shield the person from consequences and unintentionally sustain substance use. Love matters, but a combination of supporting sobriety, setting boundaries and offering professional help works better.
MythOnly the person with the addiction needs help, not the family
FactRelatives experience chronic stress and are at increased risk of anxiety and depression. In addition, changing the family’s behavior is one of the most effective ways to motivate the person to seek treatment. Helping the family is a full part of therapy.
MythNothing will change until they want it themselves
FactMotivation can be shaped by the environment. Studies of programs for relatives show that changes in loved ones’ behavior increase the likelihood that the person with the addiction will seek help. There is no need to wait for them to “hit rock bottom.”
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 Astana
| Online addiction specialist consultation | 12 000 ₸ |
| Online consultation for relatives | 12 000 ₸ |
| Addiction specialist home visit | 40 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
An online consultation for “Online help for families of people with addiction” is available to people across Astana and Akmola Region 24/7 — from home, work or while travelling. For an in-person visit, Psychiatry Online in Astana has two branches: 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Doctor home visits: all city districts and nearby settlements.
Confidential and private
Information about your visit, diagnosis and treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. We never share it with your employer, school or relatives without your consent; the only exceptions are those expressly set out by law. For an online consultation your first name is enough, video runs over a secure channel and nothing is recorded without your consent.
Questions and answers
Can a family member get help if the person with the addiction refuses treatment?
Yes, and this is often the most effective starting point. Working with the relative reduces their anxiety and changes family dynamics, which increases the chances that the loved one will agree to treatment. The specialist will help you prepare for the conversation and choose the right moment.
How often are sessions needed?
Usually once a week for 6–8 sessions, then less often. During crises — after a loved one’s relapse, when divorce is on the table or before an intervention — an extra session can be scheduled. The online format makes this quick to arrange, with no trips across the city.
Can several family members take part in a consultation?
Yes. People can join one video session from different places — for example, a mother from Baikonur district, a sister from Nura district and a brother from another city. This helps develop a shared strategy so that the family does not send the person mixed signals.
Will the person with the addiction find out that I’m getting help?
That is your decision. The consultation is confidential and protected by medical confidentiality under Kazakhstan law. Many people first attend several sessions on their own and later openly tell their loved one that they are getting support — this can set an example for them.
What should I do if the person with the addiction becomes aggressive?
Your safety and your children’s safety come first. If there is a threat of violence, call 112. The specialist will help you draw up a safety plan: where to go, whom to call and which documents to keep at hand. It is better to discuss treatment at a calm moment, not during a conflict.
Does a family member need to take medication?
In most cases, psychotherapy is enough. If the relative has developed marked depression, an anxiety disorder or insomnia, a psychiatrist may suggest medication. Prescribing requires an assessment, and some stages may be carried out in person under Kazakhstan regulations.
Where can I be seen in Astana?
Online — from anywhere in the city or region. In person — at two branches: 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. 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
