# Dialectical Behaviour Therapy (DBT) | Sierra Recovery > Dialectical behaviour therapy (DBT) at Sierra Recovery: skills for emotion regulation and distress tolerance, inside our residential programme in Spain. [Home](/) / [Therapies](/therapies/) / Dialectical behaviour therapy Therapies at Sierra # Dialectical behaviour therapy (DBT) at Sierra Recovery DBT teaches practical skills for handling overwhelming emotions and urges without turning to a substance. At Sierra it runs inside the residential programme, alongside the addiction and trauma work. Clinically reviewed by[Nerea Encinas Sánchez](/clinical-team/)Director of the centre, MSc General Health PsychologyRegistered psychologist, COPAO AO13857 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. Dialectical behaviour therapy (DBT) is a structured, skills-based talking therapy that helps you tolerate distress and steady intense emotions rather than act on them. At Sierra it is woven into the residential programme, where emotion regulation and distress tolerance are treated as core skills rather than an optional extra. ## What DBT is DBT was developed in the United States in the 1980s to help people who feel emotions very intensely and find them hard to manage. It grew out of cognitive behavioural therapy and shares its practical, present-focused approach, but it adds a second idea running alongside change: acceptance. You learn to work towards change and to accept where you are right now, at the same time. That balance is where the word dialectical comes from. It is an evidence-based therapy, widely used across the NHS and private services, and it sits comfortably within addiction treatment because so much substance use is, at heart, an attempt to cope with feelings that have become unbearable. ## Why DBT matters in addiction recovery In our model, a substance is often a way of regulating an internal state that feels too much to sit with. Take the substance away without building another way to handle that state, and the pressure it was managing does not simply disappear. DBT gives you that other way: concrete skills for the moments when an urge, a wave of anxiety or a spike of anger would once have led straight to using. Two of those skill areas do most of the work in early recovery, and both are core parts of the Sierra programme: emotion regulation and distress tolerance. ## The four DBT skill areas ### Mindfulness Mindfulness helps you stay with the present moment and notice what you are feeling without being swept away by it. It is the foundation the other skills are built on, and it steadies the habit of reacting on autopilot. ### Distress tolerance Distress tolerance is about getting through an emotional crisis without making it worse. You learn ways to ride out a strong urge or a painful moment, accept the reality in front of you, and step back from the impulsive act you would later regret. For anyone in early recovery, this is often the skill that holds the line. ### Emotion regulation Emotion regulation teaches you to recognise your emotions, understand what they are telling you, and change how you respond so that feelings no longer run the day. Over time, intense mood swings and long stretches of low mood become something you can work with rather than something that takes over. ### Interpersonal effectiveness Interpersonal effectiveness is about relationships: asking for what you need, setting healthy boundaries, and handling conflict without either giving in or blowing up. Addiction strains relationships, and repairing them is part of a recovery that lasts. ## What DBT sessions are like DBT combines individual work with a therapist and skills practice you can use straight away. Sessions focus on acceptance and change together: your therapist helps you acknowledge what you are going through rather than deny it, and then build the skills to manage it. This is learning as much as talking, and like any skill it takes practice, so it is completely normal not to master it overnight. ## How DBT fits the Sierra programme DBT is one strand of a wider residential programme built on a clinical model adapted from PROMIS Clinics, whose method was developed in the United Kingdom and has run since 1986, and on the methodology we call the Regulation Model. Alongside DBT you may work with cognitive behavioural therapy, EMDR for trauma, and holistic therapies including yoga, mindfulness, art and equine work. Your plan is personalised, because the aim is to treat the whole picture rather than a single symptom. Sierra is a registered health centre in Humilladero, Málaga (Junta de Andalucía NICA 67331). It is not a hospital or a detox unit: any detox is completed elsewhere before you arrive, and qualified nurses are part of the team throughout your stay. The residential programme is 28 days and published at £9,900. If you would like to talk through what it includes and whether it is the right setting for you, our team is here to help: see our [admissions](/admissions/) page or explore the other [therapies](/therapies/) we offer. ## Questions people ask What is dialectical behaviour therapy (DBT)? DBT is a structured, skills-based talking therapy that helps you manage intense emotions and tolerate distress without acting on harmful urges. It combines change with acceptance and teaches four skill areas: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. How does DBT help with addiction? Substance use is often a way of coping with feelings that have become overwhelming. DBT builds practical alternatives, so that when an urge or a difficult emotion arises you have skills to steady yourself rather than turning to a substance. Emotion regulation and distress tolerance are especially important in early recovery. What are the four DBT skills? Mindfulness (staying with the present), distress tolerance (getting through a crisis without making it worse), emotion regulation (recognising and steadying your emotions) and interpersonal effectiveness (asking for what you need and handling conflict). Together they help you manage thoughts, feelings and behaviour. Is DBT part of the programme at Sierra Recovery? Yes. DBT is one strand of the residential programme, alongside cognitive behavioural therapy, EMDR and holistic therapies. Your plan is personalised, and emotion regulation and distress tolerance are core parts of the work. Do I need a mental health diagnosis to benefit from DBT? No. DBT skills help anyone who struggles with intense emotions or impulsive responses, whether or not there is a formal diagnosis. Where a mental health condition sits alongside addiction, DBT is worked with as part of your wider treatment. + ## 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. Step 1 of 3 Confidential, and no obligation Registered health centre. Authorised by the Junta de Andalucía, N.I.C.A. 67331. ### Related pages [Our therapies](/therapies/)[Cognitive behavioural therapy](/cognitive-behavioural-therapy-for-alcohol-addiction/)[EMDR therapy](/emdr-therapy/)[Mental health](/mental-health-and-dual-diagnosis/)[Our programme](/our-programme-at-sierra-recovery/)[Admissions](/admissions/) --- Source: https://sierrarecoveryspain.com/dialectical-behaviour-therapy/ Retrieved: 2026-08-27 Canonical HTML version of this page: https://sierrarecoveryspain.com/dialectical-behaviour-therapy/