Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F40
- Who leads care
- A psychiatrist and a CBT psychotherapist
- Format
- Video consultations, guided exposure, assignments between sessions
- Duration
- First appointment 50 minutes; a course usually takes 4–12 sessions
- Confidentiality
- Medical confidentiality under the Kazakhstan Code “On Public Health”
- When it is urgent
- Fainting with injury at the sight of blood, or suicidal thoughts — call 103, 112, or 150
- Outcome
- Fear subsides, and you fly, travel, and see doctors again
What you should know
Fear is a normal protective reaction, but in a phobia it is triggered where real danger is minimal or absent. A person may know that air travel is one of the safest forms of transport and still turn down business trips, or understand that the elevator works properly and still climb twelve flights of stairs. ICD-10 distinguishes specific phobias, agoraphobia, and social phobia: the type matters because it determines the treatment plan.
Specific phobias are among the disorders that respond best to psychotherapy: exposure often produces marked results in a small number of sessions. At Psychiatry Online, treatment takes place over video: the specialist accompanies you at the moment you face the frightening situation — for example, when you ride an elevator in a high-rise on the left bank for the first time or watch a video of a flight. This allows you to work in a real-life context rather than just talk about the fear.
Signs and Symptoms of a Phobia
- intense fear of a specific object or situation, out of proportion to the danger
- panic, a racing heart, and trembling on contact with — or even the thought of — what frightens you
- avoiding flights, elevators, heights, travel, and medical procedures
- understanding that the fear is excessive but being unable to control it
- worrying for a long time before a situation that cannot be avoided
- turning down business trips, vacations, or medical checkups because of fear
- fainting or feeling faint at the sight of blood or needles
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.
What Causes Phobias
Phobias develop in several ways: direct traumatic experience (getting stuck in an elevator), observing someone else’s fear (a parent who was afraid of dogs), and information (stories about plane crashes). There is also a biological readiness to fear certain things — heights, snakes, enclosed spaces — which once helped humans survive. The mechanism that entrenches a phobia is avoidance: the person leaves the situation, anxiety drops, and the brain concludes that escape was possible only thanks to avoidance.
A phobia often gets worse when life demands contact with what is feared: a new job in a high-rise building, business trips, or medical procedures. Work in the civil service and large offices often involves flights to other regions and meetings on upper floors, and then avoidance starts to hold back one’s career. Blood and needle phobia is a special case: it can cause fainting due to a sharp drop in blood pressure, and the treatment technique is different.
How Online Treatment for Phobias Works
At the first video consultation, the specialist finds out exactly what you are afraid of, for how long, in which situations the fear arises, and what you do to avoid it. Together, you draw up a hierarchy — a list of situations from least to most frightening. Then exposure begins: first with images and videos on the screen, then in real life with support over video. You will need headphones, a stable internet connection, and a phone so you can connect when you are away from home.
Online exposure is suitable for most phobias, but some situations — such as a flight or a medical procedure — take place in real life, and the specialist prepares you for them in advance. In blood and needle phobia with fainting, it is important to take your physical health into account. Whether medication can be prescribed and a prescription issued depends on Kazakhstan law. If you have suicidal thoughts, call 103, 112, or 150.
How we help
Exposure therapy
According to international guidelines, this is the first-line treatment for specific phobias. Gradually, step by step, you face the frightening situation and stay in it until the anxiety subsides. The mechanism is new learning: the brain gains the experience that the expected disaster does not happen. For some phobias, even a single extended exposure session produces marked results.
Cognitive work
The specialist helps you see how you estimate the likelihood and severity of danger and test those estimates. For example, with fear of flying, you go over the sensations during turbulence and how aviation safety works. Cognitive work strengthens exposure but does not replace it: fear diminishes above all through experience.
Applied tension
This is a special technique for blood and needle phobia. The person learns to tense their muscles to keep blood pressure up and prevent fainting, and then goes through exposure. This makes it possible to have blood drawn and undergo procedures safely. The technique is easy to practice over video before a real visit to a clinic or laboratory.
Medication support
For specific phobias, medication is usually not the main treatment, and tranquilizers can interfere with exposure. If anxiety, depression, or agoraphobia is also present, the psychiatrist may discuss medication. At Psychiatry Online, the decision is made jointly, after diagnosis and a discussion of the possible options.
Myths and facts
MythA phobia is forever
FactSpecific phobias are among the most treatable disorders. Exposure therapy helps most patients significantly reduce their fear, often in a small number of sessions.
MythIt’s better to simply avoid what scares you
FactAvoidance brings relief, but it maintains and strengthens the phobia. Over time, the list of things a person avoids can grow and restrict their life, work, and leisure more and more.
MythExposure means being thrown right into your fear
FactModern exposure therapy is gradual, done with your consent and under a specialist’s supervision. You help draw up the plan, set the pace, and can say at any moment that a step is too difficult.
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 psychiatrist consultation (50–60 min) | 15 000 ₸ |
| Follow-up online consultation | 12 000 ₸ |
| One month of online psychiatric care | 60 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
You can book in Astana online or at one of two branches: 72 Bogenbay batyra St., Astana, 37 Petrova St., office 23, Astana. Our coordinator replies on WhatsApp within minutes at any time, and a doctor usually connects by video the same day; home visits are available too — all city districts and nearby settlements.
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
Can fear of flying be treated online?
Yes. Preparation, cognitive work, and exposure using videos, sounds, and virtual materials are all carried out over video. Then you take a real flight, and the specialist helps you prepare for it and review the experience afterward.
How many sessions are needed?
For a specific phobia, 4–12 sessions are often enough, and sometimes results come even sooner. For agoraphobia or several fears combined, treatment takes longer. The specialist will assess this after the first session and after drawing up the hierarchy.
Why do I faint at the sight of blood?
In blood and needle phobia, after an initial spike, blood pressure and heart rate drop sharply, which can lead to fainting. This sets it apart from other phobias, and a special technique is used for it — applied tension, which helps keep blood pressure up.
Can I do exposure on my own?
Some simple exercises are possible, but without a specialist it is easy to choose a step that is too hard or to rely on safety behaviors that undermine the result. With guidance, exposure is more effective and safer, and it leads to lasting results faster.
How do assignments between sessions work?
You carry out the steps of your hierarchy in real life: for example, riding an elevator in a business center in the Yesil district or crossing a bridge over the river. If needed, you can connect with the specialist right during the exercise.
Is it confidential?
Yes. Information about your consultation is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System.” At Psychiatry Online, you can seek help anonymously, and information may be disclosed only in cases expressly provided for by law.
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
