Home / Mental health / Depression
Depression and low mood
Residential depression treatment in Spain
A licensed 28-day residential programme in the Málaga countryside, run by an English-speaking team, for depression that has stopped responding to outpatient treatment, particularly where alcohol or drugs have joined it.
A private room as standard, a price published in full, and no referral fees paid to anyone for sending you here.
Checked for accuracy on 28 July 2026. Next review due July 2027. This page is general information about our programme and is not a substitute for advice about your own situation.
Depression is treated at Sierra Recovery inside a 28-day residential programme in the Málaga countryside, published in full at £9,900, alongside any alcohol or drug use rather than separately from it. Sierra is a registered health centre authorised for addiction healthcare, not a psychiatric hospital, so where someone is acutely unwell or at immediate risk we say so at assessment and do not admit them. For everyone else the programme is three structured group sessions a day, individual therapy three times a week, behavioural activation, a seventeen-module curriculum and an aftercare plan agreed before you leave. Below is what that actually involves, who it suits, and where the line is.
Programme
28 days residential
Published price
£9,900
Group work
3 sessions a day
Room
Private, as standard
Language
English throughout
Registration
N.I.C.A. 67331
What depression actually is, clinically
Depression is not sadness, and telling the difference matters because the treatment is different. Sadness has an object and it moves. Depression is a persistent lowering of mood and of the capacity to feel pleasure, lasting at least two weeks and usually far longer, accompanied by changes to sleep, appetite, energy, concentration and self-worth. It is a medical condition with a well-described course, not a mood or a weakness.
What brings people to residential treatment is usually not the diagnosis. It is the point at which ordinary life has stopped being possible: work has become unmanageable, the days have collapsed inwards, antidepressants have been tried and adjusted more than once, and the outpatient therapy that helped at first is no longer keeping pace with how bad things have got.
Very often alcohol or drugs have arrived alongside it, which is why this page sits on an addiction centre's website. Roughly speaking, depression and substance use co-occur far more often than either occurs alone in the population we treat, and each one worsens the other. Treating them in separate buildings is why so many people cycle.
You do not have to be certain, and you do not have to be in crisis to deserve help right now. In the UK call Samaritans on 116 123, free, any time, or text SHOUT to 85258. If you are in immediate danger call 999, or 112 anywhere in Europe. Sierra is not an emergency service and cannot respond to a crisis in progress.
The signs that it has moved beyond a bad period
| What you might notice | What it usually means |
|---|---|
| Nothing gives pleasure any more, including things you love | Anhedonia. Clinically it is one of the two core features, and it is the one people describe as the worst. |
| Waking very early and not getting back to sleep | A classic biological marker, distinct from the difficulty falling asleep that anxiety produces. |
| Everything taking enormous effort, including washing and eating | Psychomotor slowing. It is the disorder, not laziness, and it is what makes advice to just get out more useless. |
| Thinking has slowed, and decisions feel impossible | Cognitive symptoms. They lift with treatment and they are not a permanent loss of capability. |
| Drinking or using more, and it working less well each time | Self-medication. Alcohol in particular is a depressant, so it deepens the condition it is being used to treat. |
| Believing the people around you would manage better without you | A symptom producing a conclusion, not a conclusion you have reached. Please tell someone today. |
| Having tried two or more antidepressants without much change | Common, and a reason to change the setting rather than only the prescription. |
If several of those land, our short self-check takes under a minute and stores nothing.
Where the treatment actually happens
People ask for photographs before they ask about therapy, and they are right to. You are deciding whether you could live somewhere for a month. This is the place, not a stock library.
See the full gallery · how people get here.
What we are, and what we are not
This section matters more for depression than for any other page on this site, so it is stated plainly. Sierra Recovery is entered in the Registro Andaluz de Centros, Servicios y Establecimientos Sanitarios (the Andalusian register of health centres, services and establishments) under N.I.C.A. 67331, authorised by the Junta de Andalucía for the care unit atención sanitaria a drogodependientes (healthcare for drug dependency, authorised care unit U.71). That is a registered health centre with a supervised treatment residence. It is not a psychiatric hospital and it is not an inpatient mental health unit.
What that means in practice: we treat depression alongside addiction, in a residential therapeutic setting, with psychiatric care arranged through the appropriate medical route where it is needed. We do not detain anyone, we do not provide intensive psychiatric nursing, and we are not a safe place to be if you are acutely suicidal or in psychiatric crisis. If the assessment shows that, we will tell you so and help you find the setting that is right, rather than admitting you. That honesty costs us admissions and it is not negotiable. You can check our registration yourself on the Junta's public register.
Where alcohol or drugs are part of the picture and you are physically dependent, a medically supervised withdrawal is completed in an appropriate medical setting before you arrive, billed separately.
Not sure whether this is the right setting?
The assessment answers that honestly before you commit to anything, and it happens before you travel. A clinician will tell you plainly if a psychiatric service or something closer to home would serve you better.
What a day here looks like
Structure is not incidental to depression treatment. It is a substantial part of it, because the condition removes the ability to generate structure for yourself. This is the real timetable, Monday to Friday.
| Time | What happens |
|---|---|
| 08:00 | Breakfast, cooked by a Michelin-trained chef |
| 09:15 | Planning: the day is set out together |
| 10:30 | Process group, the harder one |
| 12:00 | Therapeutic group |
| 13:15 | Lunch |
| 14:30 | Psychoeducation, working through the curriculum |
| 16:00 | Group activity, often outdoors or with the horses |
| 18:30 | Dinner |
| 20:00 | Day closing, together |
Saturdays turn to holistic and body-based work. Sundays are a supervised excursion, because reconnecting with the world outside a clinic is part of the treatment rather than a break from it.
What the treatment actually involves
The programme runs Monday to Friday on a fixed structure, with Saturdays given to holistic and body-based work and Sundays to a supervised excursion. Rather than list therapy names, here is what each part of the week is for.
Three group sessions a day, five days a week
The day opens with a process group at 10:30, a second therapeutic group runs at midday, and a psychoeducation session follows lunch. A group activity fills the late afternoon and the day closes together in the evening.
Depression is powerfully isolating and it lies to you about how other people see you. Hearing your own thinking described back by someone else, and being met with recognition rather than reassurance, does something that individual work on its own cannot.
A seventeen-module curriculum, not a rest cure
The psychoeducation strand moves through a fixed curriculum built by our clinical director, covering emotions, self-esteem and self-concept, perfectionism and the inner critic, values, goals, grief, loneliness and isolation, crisis identification and management, and suicide prevention.
The cognitive work uses the ABC model, the same structure that underpins cognitive behavioural approaches: the event, the belief you attach to it, and the consequence that follows. In depression the belief is the treatment target, and it is practised and reviewed rather than discussed once.
Individual therapy three times a week
One-to-one sessions are where the material that will not surface in a group gets worked, and in depression that is usually shame, grief or an event that has never been said out loud.
You are treated by the same small team throughout, in the same house. Nobody is handed between departments, and there is no rotation of therapists mid-stay.
Doing comes before feeling like it
The most reliable psychological treatment for depression is not insight, it is activation: doing things in a graded, planned way before the motivation to do them has returned, so that mood follows action rather than waiting to precede it.
A residential setting is unusually good at this, because the structure exists whether you can generate it or not. Fixed meals, fixed sleep, daily activity outdoors and group commitments do the work that a diary at home cannot.
Yoga, meditation and getting the nights back
Saturdays turn to holistic and body-based practice: yoga, meditation and mindfulness, breathwork, art, and time outdoors. Depression is a physiological event as much as a psychological one, and sleep, appetite and the ability to sit still are usually the first things to shift.
Sleep is addressed directly with fixed hours, daylight, activity and the self-care module, because disrupted sleep both follows depression and feeds it.
What happens when you go home
Aftercare is planned before you leave rather than mentioned on the last day. For clients returning to the UK, care continues online or in person at the PROMIS clinics in London, with a weekly session for a full year, more than 48 in the twelve months after discharge, and a written handover to your GP so nothing has to be explained from scratch.
Where medication is part of your treatment, continuity of prescribing is arranged through the appropriate medical route as part of that handover rather than left to chance.
Who will actually treat your depression
A small team, in one house, in English. You are not handed between departments and there is no rotation of therapists halfway through your stay.
Nerea Encinas Sánchez
Director · General Health Psychologist
MSc General Health Psychology. Leads clinical standards, the assessment you have before you travel, and admissions.
Berenice Paramés Jones
General Health Psychologist
Individual and group psychological work inside the house, crisis follow-up and coordination of the group programme.
Marta Leal
Social worker
Family mediation, links to services back home, and preparing for independent life after discharge.
Robin Lefever
Founder of Sierra Recovery; MD, PROMIS Clinics UK
Founder of Sierra Recovery and Managing Director of PROMIS Clinics, whose method this programme adapts. PROMIS has been treating addiction in the United Kingdom since the mid-1980s, and Robin has worked in addiction treatment for around 35 years, with thousands of patients treated with the PROMIS method in the United Kingdom.
Meet the whole clinical team and their qualifications.
What is treated, and what that looks like day to day
| What you arrive with | How it is worked |
|---|---|
| Anhedonia and flatness | Behavioural activation from the first week: graded, planned activity that does not wait for motivation, plus group contact and daily time outdoors. |
| Disrupted sleep | Fixed sleep and wake times, daylight, activity and the self-care module. Sleep is usually among the first things to improve and among the most important. |
| The inner critic | The perfectionism and self-esteem modules, plus ABC work on the beliefs that convert an ordinary event into evidence against yourself. |
| Alcohol or drug use alongside | Treated in the same programme rather than referred out. Alcohol is a depressant and it is very often the reason a depression will not lift. See dual diagnosis. |
| Grief | The grief module, which covers bereavement and also the losses that are not deaths: health, roles, relationships, the life you expected. |
| Suicidal thinking | The suicide prevention and crisis management modules, a safety plan written with you, and an honest assessment before admission of whether this setting is safe for you at all. |
| Medication | Arranged and reviewed through the appropriate medical route. We do not start, stop or adjust psychiatric medication ourselves, and we coordinate with whoever prescribes it. |
Treatment options for depression, and how they compare
Residential rehab is one treatment option among several, and it is not automatically the right one. Being straight about that is more useful to you than a page that pretends otherwise.
| Option | What it involves, and who it suits |
|---|---|
| Residential rehab inpatient treatment | Living at the centre for the whole programme. It suits depression that has not responded to outpatient treatment, particularly where alcohol or drugs have joined it and the days have stopped functioning. |
| Outpatient treatment day programmes and therapy sessions | Attending sessions and going home between them. The usual and appropriate starting point, through NHS talking therapies or a private therapist, alongside your GP. |
| Community and NHS services | Free local drug and alcohol treatment services, reached through your GP or by self-referral. Waiting times vary and residential placements are rationed, but the support is real and it costs nothing. For many people this is the right first step rather than a lesser one. |
| Mutual aid and support groups | Free peer support meeting in person and online, everywhere, with no waiting list and no cost. Worth using alongside whatever else you choose rather than instead of it. |
A treatment plan should be built around your circumstances. If an outpatient or community route fits you better, we will say so at assessment and we will not charge you for the conversation.
The therapies used, in plain terms
Every centre lists the same acronyms, so here is what each one actually is and where it appears in the week.
| Therapy | What it is, and when you would meet it here |
|---|---|
| Cognitive behavioural therapy CBT, and the related REBT | Evidence-based work on the link between an event, the belief you attach to it and what you then do. Taught through the ABC model in psychoeducation, practised in group therapy and applied between sessions. It is the backbone of the cognitive work rather than an optional extra. |
| Acceptance and commitment therapy ACT | Learning to have a difficult feeling without having to act on it, and choosing behaviour by your values instead. Module eight, on emotions, is built on it. |
| Dialectical behaviour therapy DBT | Distress tolerance, emotional regulation and interpersonal skills, used where emotions arrive faster and larger than they can be managed. See DBT. |
| EMDR | A structured trauma therapy, used where trauma is driving the use and always after stabilisation rather than before it. See EMDR. |
| Group therapy | Three group sessions a day, five days a week: a process group, a therapeutic group and psychoeducation. It is the largest single component of the treatment programme. See group therapy. |
| Individual therapy one-to-one counselling | Three therapy sessions a week with the same clinician throughout, where material that will not surface in a group gets worked. |
| Family therapy | Offered where it is wanted, in person or online, because the people around you are part of what happens next. See the family programme. |
| Motivational interviewing | Used throughout rather than booked as a session. It is the stance the team takes: working with your reasons for change rather than arguing you into someone else’s. |
| Holistic therapies | Yoga, mindfulness and meditation, breathwork, art and equine work, on Saturdays and through the week. See equine therapy and all our therapies. |
Every element above is delivered by the clinical team as part of the residential programme. Your treatment plan sets out which of them apply to you, and it is reviewed during the stay rather than fixed on day one.
Where else to get help, free
Not everyone needs residential rehab, and nobody should be waiting on a private programme before they get any support at all. Everything below is free, and none of these organisations pays or receives a fee from us.
| Organisation | What they do |
|---|---|
| NHS talking therapies | Free psychological therapy for anxiety and depression in England, available by self-referral without going through your GP first. |
| Mind | Mental health information, advocacy and local services across England and Wales. |
| Samaritans | Free and confidential, 24 hours a day on 116 123, for anyone struggling to cope or having thoughts of suicide. |
| NHS drug and alcohol services | Free local treatment services, reached through your GP or by self-referral. The usual starting point for community-based drug and alcohol treatment. |
| We Are With You | Free, confidential support for drug, alcohol and mental health problems, in person in many areas and by webchat. |
| Adfam | Support and information for families and friends affected by someone else’s drug, alcohol or gambling use. |
Sierra Recovery neither pays nor accepts referral fees, so nothing on this list depends on where you go. If a free or community service is the right fit for you, use it.
How to get ready
- Compare on licence, not on photographsAsk any centre abroad for its registration number and the register it sits on, then look it up yourself. Ours is N.I.C.A. 67331 on the Junta de Andalucía register, for addiction healthcare rather than psychiatric inpatient care.
- Bring the treatment historyWhich antidepressants, at what doses, for how long, and what happened. Which therapies, and for how long. This is the single most useful thing you can arrive with, and it stops the first fortnight repeating work that has already failed.
- Be honest about alcohol and drugsNot as a confession. It determines whether a medically supervised withdrawal is needed first, and it very often explains why the depression has not responded to treatment so far.
- Ask what the price actually includesOurs is published: private room, meals, the core therapy programme, and a year of weekly UK aftercare, with medical, psychiatric, laboratory and hospital costs quoted separately. You get an itemised written quotation before admission.
- Tell us if you are having thoughts of suicidePlainly and at assessment. It does not automatically exclude you, and hiding it is the one thing that could put you somewhere unsafe.
How Sierra compares with private residential depression treatment at home
| What you get | Sierra Recovery | Typical private residential clinic |
|---|---|---|
| 28-day residential programme | £9,900, published in full | UK £12,000–£40,000 · Australia A$30,000–A$50,000 |
| Is the price on the website | Yes, in full | Usually "contact us for pricing" |
| Your own private room | Included as standard | Often an upgrade |
| Referral fees paid to third parties | None | Common |
| Written itemised quotation before admission | Yes | Varies |
| Distance from the people and places tied to use | Rural Andalucía | Usually close to home |
| Medically supervised detox | Arranged and quoted separately | Quoted separately |
Comparison figures are the published ranges collected on our cost calculator: the United Kingdom at roughly £12,000 to £40,000 a month, Australia at roughly A$30,000 to A$50,000, and the United States at roughly $20,000 to $40,000 for a 30-day programme. New Zealand, South African and Canadian ranges are set out on the country cost guides. Indicative, not a quotation. Every clinic sets its own fees.
When depression and addiction sit together
They usually do, and the order they arrived in matters less than most people expect. Alcohol lowers mood over time, so drinking on a depression deepens it. Equally, a depression that has gone untreated for years is one of the most reliable routes into dependence. Sending one to a rehab and the other to a mental health service means neither is treated in the presence of the other, which is the whole problem. At Sierra both are worked in the same programme, in the same house, by the same team. See dual diagnosis and mental health.
When is it time?
If you have been treated as an outpatient and are not getting better, if the days have stopped functioning, or if alcohol or drugs have joined the picture, that is enough. You do not need to be at the worst point you can imagine. Depression is unusual among illnesses in that it will argue convincingly that you do not deserve treatment, and that argument is a symptom rather than an assessment.
Talk to a clinician today
You will speak to our admissions team, all of them clinicians. Confidential, no obligation, and we will tell you honestly whether this programme fits or whether something closer to home would serve you better.
Questions people actually ask
Do you treat depression on its own, without addiction?
We treat depression as part of a residential programme built around addiction and dual diagnosis, so the honest answer is that Sierra suits people whose depression sits alongside alcohol or drug use, or who want intensive structured psychological treatment in a residential setting. If your depression is severe and there is no substance use at all, a specialist mental health service may fit you better, and we will say so at assessment.
Is Sierra a psychiatric hospital?
No. Sierra is a registered health centre authorised for addiction healthcare, not a psychiatric hospital or an inpatient mental health unit. We do not detain anyone and we do not provide intensive psychiatric nursing. Where psychiatric care or medication is part of your treatment, it is arranged through the appropriate medical route.
What if I am having suicidal thoughts?
Tell us at assessment. It does not automatically mean we cannot help, but it does change what has to be in place, and if you are acutely at risk a residential centre abroad is not the right setting and we will say so. If you are in crisis now, call Samaritans on 116 123 in the UK, text SHOUT to 85258, or call 999 or 112 if you are in immediate danger.
Can I keep taking my antidepressants?
Yes, and you should not stop them to come here. Psychiatric medication is reviewed and continued through the appropriate medical route, coordinated with whoever prescribes it. We do not start, stop or adjust it ourselves, and a written handover to your GP is part of standard aftercare.
How long is the programme and what does it cost?
It is a 28-day residential programme, published in full at GBP 9,900. That covers a private room, meals, the core therapy programme, and a year of weekly UK aftercare. Psychiatric, medical, laboratory and hospital detox costs are quoted separately. You get an itemised written quotation before admission.
Will four weeks actually change anything?
Four weeks does not cure depression, and anyone promising that is selling something. What a structured month reliably does is break the collapse of routine that maintains it, get sleep and activity back on a footing, treat any substance use that is holding it in place, and send you home with a plan and continuing care rather than a discharge letter.
How do I get help for depression?
The first step towards recovery is an assessment, and ours is free and carries no obligation. You can also seek help through your GP, through a free local drug and alcohol treatment service, or through a mutual aid group, and none of those routes costs anything. If you want to talk it through with a clinician, call +44 1202 653136 and you will reach our admissions team. NHS talking therapies take self-referrals in England without going through your GP, and they are free.
What does depression treatment involve, from start to finish?
The course of treatment runs in four stages. An assessment before you travel, which decides whether a medically supervised detox is needed first. Any detox, completed in an appropriate medical setting and billed separately. Then the 28-day residential treatment programme itself: three group therapy sessions a day, individual therapy three times a week and the seventeen-module curriculum. Then aftercare, agreed before you leave and continuing online or in person in London.
How much does depression rehab cost, and what affects the price?
Sierra publishes a single figure: GBP 9,900 for the 28-day residential programme, with a private room included. What changes the total is whether you need a medically supervised detox, which is arranged and billed separately, and any medical, psychiatric or laboratory costs. Private residential rehab elsewhere commonly runs from around GBP 12,000 to GBP 40,000 a month in the United Kingdom and from roughly A$30,000 to A$50,000 in Australia. You get an itemised written quotation before admission, and we neither pay nor accept referral fees.
What are the signs and symptoms of depression?
The symptoms of depression are a persistently low mood and a loss of pleasure lasting at least two weeks, with changes to sleep, appetite, energy, concentration and self-worth. Early waking, everything taking enormous effort and believing others would manage better without you are the ones that most often bring people to residential treatment.
Is lasting recovery from depression actually possible?
Yes, and the evidence is better than the public conversation suggests. What predicts long-term recovery is not willpower but what is in place afterwards: continuing therapy, a treated mental health condition, a support network and a relapse plan that was written before it was needed. That is why completing depression rehab matters less on its own than what follows it, and why aftercare is planned during the stay, so it is in place before you leave.
How can I help someone with depression?
Start by getting support for yourself, because living alongside someone with an addiction is its own burden and Adfam and Al-Anon exist for exactly that. Beyond that: raise it when they are not intoxicated, be specific about what you have seen rather than general about what they are, and offer a concrete next step such as an assessment or a call to a free service. Ultimatums delivered in anger rarely work. We speak to families every day and that conversation costs nothing.
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Talk to a clinician today
You will speak to our admissions team, English-speaking clinicians who know the programme and the people in it. Callback within 24 hours.
Registered health centre. Authorised by the Junta de Andalucía, N.I.C.A. 67331.
