Reviewed by: Madina Abdrakhmanova, addiction psychologist · updated 6 Nov 2026
Key facts
- Who provides care
- A psychotherapist trained in couples therapy
- Format
- Joint video sessions, sometimes individual sessions
- Duration
- Sessions of 60–80 minutes, a course of 8–20 sessions
- Anonymity
- Confidential, medical confidentiality under Kazakhstan law
- When it’s urgent
- Violence, threats, suicidal thoughts — call 112 or 103
- Outcome
- Understanding your conflict cycle, reconnecting and making a conscious decision
What you should know
Conflicts in a couple are rarely only about the subject of the argument — money, household chores or relatives. Relationship research shows that a couple’s resilience depends on how partners respond to each other’s emotional bids: whether they respond, ignore them or attack. When one partner feels unheard, they escalate their demands, the other defends or withdraws, and the cycle becomes entrenched. Couples therapy makes this cycle visible and helps partners step out of the roles of “pursuer” and “withdrawer.”
The online format removes many barriers: there is no need to find a babysitter, juggle two people’s work hours or drive across the whole city through wind and ice. At Psychiatry Online, a couple can join in the evening from home after the children are asleep, or even from different places if one partner is on a business trip. For couples where both partners work late in government agencies or offices on the left bank, this is often the only way to attend therapy regularly.
When a Couple Should See a Therapist
- arguments follow the same script and end without resolution
- partners are increasingly silent, avoid conversations and spend time apart
- a crisis of trust after infidelity, lies or hidden financial decisions
- declining closeness and intimacy, a feeling that you live like roommates
- difficulties after the birth of a child, a move or a job loss
- disagreements about raising children, the role of relatives or plans for the future
- you are discussing a breakup but want to make the decision consciously
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 Get Stuck in a Vicious Circle of Conflict
Attachment theory explains that, for an adult, a partner is a source of security, much as a parent is for a child. When the bond feels threatened, ancient defensive reactions kick in: protest, demands, criticism or, conversely, freezing and withdrawal. These reactions are understandable, but the partner perceives them as an attack or indifference. This creates a negative cycle in which each partner defends against the other, even though both want closeness.
Research behind the Gottman Method identifies behaviors that are especially destructive for relationships: criticizing a person’s character rather than their behavior, contempt, defensiveness and stonewalling. External stress — workload, financial difficulties, life transitions — drains the energy available for paying attention to one’s partner. The long winter months, when a couple spends more time in a confined space, can bring accumulated tension to the surface.
How an Online Couples Therapy Session Works
The first session is usually joint: the therapist learns what each partner wants from therapy, the history of the relationship, the couple’s strengths and the main conflicts. Short individual sessions are sometimes held afterward so that each partner can share what is hard to say in front of the other. For sessions, it is convenient to sit side by side in front of one screen with a good camera and microphone, or to join from separate rooms with headphones. It is important that children and other people are not nearby.
Couples therapy is not provided if there is ongoing physical violence or intimidation in the relationship: joint sessions may be dangerous for the person being harmed, so individual help and a safety plan come first — if there is a threat, call 112. If a partner has severe depression, an addiction or thoughts of suicide, an in-person examination by a psychiatrist or addiction specialist may be needed.
How we help
Emotionally Focused Therapy
EFT is based on attachment theory and has a strong evidence base. The therapist helps partners recognize their negative cycle, see the vulnerable feelings behind anger and withdrawal — fear, loneliness, hurt — and learn to express them in a way the partner can respond to. This gradually restores the emotional bond and a sense of safety.
The Gottman Method
This approach is based on many years of observing couples. It includes a relationship assessment and work on the skills of constructive disagreement, repair after an argument, and strengthening friendship and mutual respect. Partners receive concrete exercises: how to start a difficult conversation gently, how to take a break when emotions run too high and how to notice the good.
Working Through a Crisis of Trust
After infidelity or a serious lie, therapy goes through stages: stabilization and relief of acute pain, exploring what led to the crisis, and rebuilding trust through transparency and new agreements. The therapist does not pass judgment but helps both partners go through this process and reach a decision they can live with.
Communication Skills
Couples practice active listening, “I” statements and discussing needs instead of making accusations. The skills are practiced on real topics, and homework helps consolidate them in everyday life. The online format is convenient because the exercises are done in the same setting where conflicts usually happen.
Myths and facts
MythPeople go to a couples therapist when it’s already too late
FactMany couples do seek help after years of conflict, but results are better if you start earlier. Couples therapy is also useful as prevention — for example, before a wedding or after the birth of a child.
MythThe therapist will decide who is right and who is to blame
FactA couples therapist’s job is not to be a judge but to help both partners see their shared cycle and find a way out. The therapist does not take sides and supports both partners through the process of change while remaining neutral.
MythThe goal of couples therapy is always to save the relationship
FactThe goal is to help the couple make a conscious decision. For many, that means restoring the relationship, but sometimes partners conclude that they should separate and learn to part with less harm to themselves and their children.
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 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
An online consultation for “Online couples therapy” 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 I come to couples therapy alone?
Yes, you can start individually if your partner isn’t ready yet. You will explore your own role in the conflicts and learn new ways of responding. Often, changes in one partner’s behavior shift the couple’s dynamic too, and the other partner later joins joint sessions.
How many sessions will we need?
Short-term couples therapy usually includes 8–20 sessions held one to two weeks apart. After a crisis of trust or with long-standing conflicts, more may be needed. The therapist regularly reviews progress with the couple and decides together with them when it is time to finish.
Can we join from different places?
Yes. If partners are in different cities or one is on a business trip, each joins via their own link. However, when possible, it is better to sit together in front of one screen: this way the therapist can see how you interact, and you can do connection exercises.
Will the therapist tell my partner what I said in private?
Confidentiality rules are agreed on at the start of the work. Many therapists follow a “no secrets” policy that protects trust within the couple, but they explain it in advance. Information about sessions is protected by medical confidentiality under Kazakhstan law.
Does couples therapy help after infidelity?
Yes, this is one of the most common reasons couples seek help. Research shows that many couples can rebuild trust through structured work. What matters is that both partners are willing to take part, that the affair has ended, and time: the path to recovery usually takes months.
How do we find time for sessions if we both work?
The online format allows sessions in the evening and on weekends. Many couples in which both partners work at ministries or companies in Yesil district choose late evenings after the children have gone to bed and join from home.
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
