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, with individual sessions when needed
- Duration
- Each session lasts 60–90 minutes; a course includes 8 to 20 sessions
- Confidentiality
- Medical confidentiality under the Code of the Republic of Kazakhstan; anonymous requests
- When it’s urgent
- Violence, threats, or suicidal thoughts — call 102 (police), 103, or 112
- Outcome
- Understanding of your conflict cycles, communication skills, and a conscious decision as a couple
What you should know
Couples therapy is a distinct field of psychotherapy that views the relationship between two partners as a system. Difficulties in a couple are rarely explained by the actions of only one person: more often, they are linked to repeating cycles of interaction in which one partner’s reaction triggers a defensive reaction in the other. The specialist helps the partners recognize these cycles and develop safer, more supportive ways of communicating.
Research confirms the effectiveness of several approaches to couples therapy, including emotionally focused therapy and integrative behavioral couple therapy. In addition, relationship work is used as part of the treatment of depression and addiction in one of the partners. The online format at Psychiatry Online lets couples in Kazakhstan meet with a specialist from home and, if needed, join from different locations.
When a Couple Should See a Specialist
- recurring arguments about the same issues that never get resolved
- a sense of emotional distance and loneliness even when you are together
- a crisis of trust after infidelity, lies, or hidden financial decisions
- less intimacy and difficulties in the couple’s sex life
- disagreements about raising children, household matters, or relatives
- periods of silence, mutual reproach, and resentment that keeps building up
- doubts about the future of the relationship and difficulty making a decision
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 Relationships Reach a Dead End
According to attachment theory, in close relationships each partner seeks a sense of security and the other’s emotional availability. When this need is not met, one partner may start to demand and criticize, while the other withdraws and avoids. This creates a “pursue–withdraw” cycle that deepens mutual disappointment, even though both partners are actually seeking closeness.
Relationships are also affected by life stages and outside stress: the birth of children, illness, financial difficulties, relocation, and fatigue. Differences in values, expectations, and ways of expressing feelings, shaped in each partner’s family of origin, become a source of misunderstanding. Couples therapy helps partners see these mechanisms and discuss them calmly, without blaming each other.
What Happens in an Online Couples Session
The first session is usually held jointly: the specialist gets to know the couple and learns about the history of the relationship, the main difficulties, and each partner’s expectations. Sometimes this is followed by one individual session with each partner. For the video session, it is important to choose a place without children or other people around and to use a device with good sound. The specialist makes sure each partner can have their say and helps them hear each other in a new way.
Joint therapy is not carried out when there is ongoing physical or psychological abuse, as an open conversation could put one of the partners at risk. In that case, individual help and a safety plan are needed; if you are under threat, call 102 or 112. If a partner has depression, an addiction, or a mental disorder, an in-person consultation with a psychiatrist in Kazakhstan is also needed.
How we help
Emotionally focused therapy
This approach is based on attachment theory. The specialist helps the partners recognize their negative cycle of interaction, express the vulnerable feelings hidden behind anger or withdrawal, and develop new ways of responding to each other. The method has a strong evidence base and is also used after infidelity and serious conflicts.
Integrative behavioral couple therapy
This approach combines training in communication and problem-solving skills with work on accepting the partner’s differences. Couples learn to talk about difficulties without blame, reach agreements, and at the same time accept those traits in each other that cannot be changed. The method has been well studied in clinical research and is suitable for online sessions.
The Gottman Method
This approach is based on many years of observing couples and describes the factors that damage and strengthen relationships. Partners learn to notice criticism, contempt, defensiveness, and stonewalling and to replace them with constructive ways of communicating, while strengthening their friendship and shared sense of meaning. Many of the exercises are easy to do at home between sessions.
Therapy for decision-making crises
Sometimes partners are not sure whether they want to continue the relationship. The specialist helps them clarify their feelings, doubts, and expectations without pushing them toward a particular decision. The outcome may be a decision to work on the relationship or to separate carefully, with minimal harm to themselves and their children, while preserving mutual respect.
Myths and facts
MythCouples therapy is the last resort before divorce
FactThe earlier a couple seeks help, the more likely they are to change negative cycles. Many couples come at the stage of the first difficulties, after the birth of a child, or after a move, to prevent resentment from building up and conflicts from becoming chronic.
MythThe therapist will take one partner’s side
FactThe specialist stays neutral and works with the relationship, not with one person’s fault. They help each partner feel heard and make sure the session remains safe for both participants.
MythThe goal of couples therapy is to save the marriage at any cost
FactThe goal is to help partners understand each other and make a conscious decision. Most often, this means improving the relationship, but sometimes a couple concludes that they should separate, and therapy helps them go through this process with care.
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 Kazakhstan
| 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 from any city in Kazakhstan — all you need is a smartphone or computer with internet. In 45 cities we also offer home visits and in-person appointments. Choose your city at the top of the page to see addresses and visit areas.
Confidential and private
An online appointment in Kazakhstan 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 out your feelings, understand the dynamics of the relationship, and find the right words to talk to your partner. Sometimes changes in one partner affect the whole couple, and the other partner joins later.
Can we do couples therapy from different cities?
Yes, the online format allows each partner to join from their own device. This is convenient for couples who are temporarily living apart or travel a lot. The specialist agrees on the session rules with both partners in advance and checks the connection.
Does therapy help after infidelity?
Yes, dealing with the aftermath of infidelity is one of the most common reasons couples seek help. Therapy helps partners get through the acute phase, understand the causes, rebuild trust, or make a decision about the future. The process takes time and requires both partners to be willing to talk openly.
Does the therapist tell one partner what the other said?
The confidentiality rules are discussed in advance. Usually, the therapist does not keep secrets that matter for the joint work, but also does not disclose individual conversations without an agreement. Information about therapy is protected by medical confidentiality under the Code of the Republic of Kazakhstan.
How long does couples therapy take?
The length depends on what the couple is seeking help with and how deep the difficulties are. Many couples notice changes after a few sessions, and a full course takes 8 to 20 sessions. After the main stage, maintenance sessions may be held every few weeks.
What if there is violence in the relationship?
If there is violence, joint therapy does not begin until safety has been ensured. The specialist will offer individual help and help you draw up a safety plan. In case of immediate threat, call 102 or 112, and if there is a threat to life, call 103.
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
