Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- Who provides care
- A psychotherapist, a clinical psychologist, and a psychiatrist-narcologist (addiction specialist)
- Format
- Individual and group video sessions, contact with a specialist at moments of crisis
- Duration
- Each session lasts 45–60 minutes; the program runs from 6 to 12 months or longer
- Confidentiality
- Medical confidentiality under the Code of the Republic of Kazakhstan; anonymous participation
- When it’s urgent
- Severe intoxication, overdose, or suicidal thoughts — call 103 or 112
- Outcome
- Stable remission and a personal relapse prevention plan
What you should know
A lapse, or relapse, is a return to using a psychoactive substance or to addictive behavior after a period of abstinence. International clinical guidelines regard relapses as a common feature of the chronic course of addiction, not as a failure of treatment. That is exactly why relapse prevention is treated as a separate area of care and continues after the main course of treatment is complete.
The relapse prevention model, developed within the cognitive behavioral approach, views a relapse as a process that begins long before the first drink or dose. Online support at Psychiatry Online makes it possible to meet with a specialist regularly without interrupting work or family life. For people in Stepnogorsk who have completed an inpatient or rehabilitation program, it is a way to stay in touch with their therapist and get help in time.
Early Warning Signs of an Approaching Relapse
- growing irritability, anxiety, or low mood for no obvious reason
- thoughts of using coming back, along with memories of its “pleasant” side
- dropping support meetings, therapy, and contact with sober people
- disrupted sleep, eating, and daily routine
- looking for excuses to be in places or with people associated with using
- feeling sure the problem is solved and that you can “try just a little”
- stress building up at work or at home with no way to release it
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
After a person stops using, the changes in brain function that developed over years of addiction persist for a long time. The reward system remains sensitive to cues associated with the substance: places, people, smells, and emotions. Encountering such cues can trigger an intense craving that seems to come out of nowhere. In addition, sleep problems, low mood, and anxiety are common during the first months of sobriety.
Relapse is made more likely by stress, conflicts, loneliness, fatigue, and being unable to cope with strong emotions without the familiar way out. Overconfidence is also dangerous, when a person stops taking precautions. Relapse prevention teaches people to recognize these factors in advance, plan their actions, and use support before the craving becomes uncontrollable.
How the Online Program Works
At the first session, the specialist and the patient review the history of the addiction, previous relapses, the current condition, and available resources. A personal plan is drawn up: a list of high-risk situations, early warning signs, and specific actions to take in each case. Video sessions follow an agreed schedule and require a device with a camera and a place for a confidential conversation. Between sessions, the patient keeps a mood diary and can contact the specialist.
The online format is not suitable for treating acute intoxication or severe withdrawal after a relapse — in such cases, an in-person examination, a doctor’s home visit in Stepnogorsk, or inpatient care is needed. In case of overdose, seizures, confusion, or suicidal thoughts, call 103 or 112. Once the condition has stabilized, online sessions can continue.
How we help
Cognitive behavioral model
The patient learns to identify the chains of thoughts, emotions, and actions that lead to using and to break them at an early stage. Refusal, problem-solving, and planning skills are practiced. Special attention is paid to the abstinence violation effect: if a single lapse occurs, it is important not to see it as a total failure and to return to the plan right away.
Mindfulness and working with cravings
Mindfulness-based relapse prevention teaches people to observe a craving as a temporary state without acting on it. The patient learns techniques that help ride out the peak of the urge, reduce reactivity to stress, and better understand their emotions. These skills are easy to learn in online sessions and through practice at home.
Medical monitoring
The addiction specialist assesses the patient’s condition, sleep, and mood and, when indicated, discusses relapse prevention medication from the appropriate drug groups. Whether a medication can be prescribed and a prescription issued depends on the legislation of the Republic of Kazakhstan and the requirement for an in-person examination. Medication support is combined with psychotherapy but does not replace it.
Social support
An important part of the program is rebuilding a sober social circle: family, friends, mutual support groups, and new interests. The specialist helps establish a daily routine, find activities that bring satisfaction, and repair relationships with loved ones. Relying on the people around you reduces the risk of isolation, which often comes before a relapse.
Myths and facts
MythA relapse means it was all for nothing
FactRelapse is common in chronic illnesses, including addiction. The experience of sobriety and the skills you have learned are not lost. What matters is getting back into treatment quickly and analyzing the causes so the plan can be adjusted.
MythAfter rehab, no support is needed
FactThe first year of remission is considered the period of highest risk. According to research, continuing maintenance sessions after the main treatment is associated with more lasting results.
MythIf you have cravings, the treatment didn’t work
FactCravings can appear even after a long period of sobriety, and this is to be expected. The goal of relapse prevention is to learn to cope with them without going back to using, not to get rid of every thought about the substance.
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 Stepnogorsk
| 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
An online consultation for “Relapse prevention online” is available to people across Akmola Region 24/7 — from home, work or while travelling. For an in-person visit, Psychiatry Online in Stepnogorsk has two branches: 153 Tselinnaya St., Stepnogorsk and 153 Abaya St., office 22, Stepnogorsk. Doctor home visits: all city districts and nearby settlements.
Confidential and private
An online appointment in Stepnogorsk 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 completing detoxification or the main course of treatment. However, you can start at any stage of remission, including after a long period of sobriety, if warning signs have appeared. The earlier a personal plan is drawn up, the better prepared a person is for difficult situations.
How often are the sessions?
In the first months of remission, sessions are usually held weekly, and later the frequency may drop to once or twice a month. The schedule is tailored individually and changes during stressful events. In a difficult moment, you can contact the specialist outside the regular schedule.
What should I do if a relapse has already happened?
It is important not to hide what happened and to contact a specialist as soon as possible. An online consultation will help assess your condition, decide whether medical care is needed, and get back to the plan. If you feel severely unwell after using, call 103 or 112.
Is the program suitable for gambling addiction?
Yes, the principles of relapse prevention also apply to gambling addiction. The program includes work on triggers, financial risks, restricting access to gambling, and emotional regulation. The specialist adapts the plan to the specific type of addiction.
Can I take part anonymously?
Yes, you can take part without revealing your full name. Information about your consultations is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System.” It may be disclosed only in cases expressly established by law.
Can loved ones be involved?
With the patient’s consent, relatives can take part in some sessions. This helps them recognize warning signs, support sobriety without control or reproach, and understand what to do if a relapse occurs. The family can also have its own consultations.
Where can I be seen in Stepnogorsk?
Online — from anywhere in the city or region. In person — at two branches: 153 Tselinnaya St., Stepnogorsk and 153 Abaya St., office 22, Stepnogorsk. 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
