Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- Who provides care
- A psychotherapist and an addiction medicine doctor
- Format
- Regular video sessions + unscheduled contact
- Duration
- Sessions of 45–50 minutes, a program of 6–12 months
- Anonymity
- Confidential, no registration on the state registry
- When it’s urgent
- Severe withdrawal after a relapse, suicidal thoughts — call 103 or 112
- Outcome
- A personal prevention plan and stable remission
What you should know
A relapse in addiction is not an instant event but a process. The clinical relapse prevention model describes it as a sequence: first emotional changes (irritability, isolation, lack of sleep), then a mental stage (recalling “good” episodes of use, searching for excuses), and only then physical use. This means a relapse can be noticed and stopped long before the first drink or bet.
The risk is highest in the first 6–12 months after treatment, when the skills of sober living have not yet become automatic. Regular video sessions at Psychiatry Online make it possible to track warning signs without trips to the clinic. This is especially important in the cold season: on windy winter evenings, when daylight is short and you don’t feel like going out, many residents of both the right and left banks notice their mood dropping — and that is one of the key early warning signs of relapse.
Warning Signs That Your Relapse Risk Is Rising
- your sleep becomes shallow, and you feel irritable and tired
- you increasingly remember pleasant episodes of using
- thoughts like “just once won’t hurt” or “I’ve got this, I’m back in control” appear
- you are drifting away from people who support your sobriety
- you skip sessions with your therapist or support groups
- stress is building up at work, while your ways of unwinding are shrinking
- you find yourself back in places and with people associated with using
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 Relapses Happen Even After Successful Treatment
After a person stops using, changes in the reward system persist for months. Neural links between triggers — places, times, people and emotions — and the expectation of pleasure remain, so cravings can suddenly appear in a familiar situation. In addition, many people experience lingering symptoms: sleep problems, apathy and anxiety, which increase vulnerability.
A psychological mechanism adds to the risk: after a single episode of use, the abstinence violation effect kicks in — a feeling that “it’s all ruined,” which pushes the person to continue. Chronic stress, conflicts, loneliness, office parties and holidays, as well as seasonal dips in mood, create high-risk situations. Relapse prevention teaches you to prepare a response to each of them in advance.
How the Online Relapse Prevention Program Works
Sessions take place by video every 1–2 weeks. Together with you, the specialist maps out your personal triggers, a list of early warning signs and a concrete action plan: whom to call, what to do, where to go. At each session, situations from the past days are reviewed, and skills for saying no and coping with cravings are practiced. You will need privacy, headphones and a stable internet connection; it is convenient to join from home or from your car during a lunch break.
If a relapse has already happened and pronounced withdrawal symptoms have appeared — shakiness, vomiting, insomnia — an in-person examination or a doctor’s home visit is needed. In case of seizures, hallucinations, confusion, an overdose or thoughts of suicide, call 103 or 112 immediately. Adjusting medication support requires a doctor’s assessment under Kazakhstan regulations.
How we help
The Relapse Prevention Model
This is a structured cognitive behavioral program with a strong evidence base. It teaches you to identify high-risk situations, recognize early warning signs and prepare coping strategies in advance. The patient learns to see relapse as a process that can be interrupted at any stage, rather than as something inevitable that strikes out of nowhere.
Craving Coping Techniques
A craving is like a wave: it builds, peaks and subsides if it is not reinforced by using. Sessions practice delay and distraction techniques, breathing exercises and the skill of “urge surfing” — observing a craving without acting on it. The online format makes it possible to train these skills at home, where cravings usually arise.
Mindfulness-Based Relapse Prevention
Mindfulness techniques help you notice thoughts and bodily sensations linked to cravings without reacting to them automatically. Research shows that combining mindfulness practices with relapse prevention reduces relapse rates. Short daily exercises are easy to do at home, and the experience is discussed in sessions.
Working Through a Lapse
If a lapse occurs, it is important not to let it turn into a full relapse. The specialist helps quickly work out what led to it, reduce shame and get back to the plan. If needed, a doctor’s home visit or an in-person appointment is arranged. This approach shortens the period of use and reduces the severity of health consequences.
Myths and facts
MythA relapse means treatment didn’t work
FactRelapse is common in chronic disorders, like a flare-up of asthma or high blood pressure. It shows which skills need strengthening. The important thing is to return to treatment quickly rather than abandon it.
MythIf you haven’t drunk for a year, the risk of relapse is gone
FactThe risk decreases over time but does not disappear entirely. Triggers can fire even years later, especially during periods of severe stress. Maintenance sessions, even once a month, help preserve your skills.
MythRelapse prevention is only for people with weak willpower
FactRelapse prevention is a standard part of addiction treatment according to clinical guidelines. It is based on understanding the mechanisms and on skills, not on willpower. The better prepared your plan, the less you have to rely on effort in the moment of craving.
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 addiction therapy session | 15 000 ₸ |
| Online support program (one month) | 80 000 ₸ |
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 Astana: same-day video appointments and two branches for in-person visits — 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Our mobile team works around the clock: all city districts and nearby settlements. If you live elsewhere in Astana and Akmola Region, starting online is usually easiest.
Confidential and private
An online appointment in Astana 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
When should relapse prevention start?
Ideally, right after the acute stage of treatment is completed: detox, inpatient care, rehabilitation or coding. It is in the first months that the risk is highest. But you can join the program later as well, including after a relapse has already happened.
How often are sessions needed?
In the first months, once a week; then every two weeks; and in stable remission, once a month. During periods of increased risk — for example, the New Year holidays, a job change or the dark winter months — the frequency can be increased.
Can I contact a specialist if I have a strong craving right now?
Yes, consultations at Psychiatry Online are available around the clock. A short unscheduled session helps you ride out the peak of a craving without relapsing. It is also useful to prepare a list of people you can call at such a moment in advance and keep it at hand.
Is medication needed for relapse prevention?
Sometimes, yes: certain medications reduce cravings and lower the risk of relapse. The decision is made by an addiction specialist after an assessment, and prescribing follows Kazakhstan regulations, often with an in-person stage. Psychotherapeutic work remains the foundation.
Is the program suitable for gambling addiction?
Yes. The principles of relapse prevention are the same for different types of addiction: recognizing triggers and early warning signs and practicing skills. The content differs — for example, in gambling addiction, financial restrictions and blocking access to gambling platforms are important.
Can sessions fit into a busy work schedule?
Yes. Employees of government agencies and offices in Yesil and Baikonur districts usually join early in the morning, during a lunch break or in the evening. A video session takes about 50 minutes and requires no travel, so it is easy to keep up even in the busiest weeks.
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
