# Mental Health and Dual Diagnosis Treatment | Sierra Recovery > Mental health treated alongside addiction in Malaga: depression, anxiety, trauma, PTSD and burnout in one 28-day residential programme at a published GBP 9,900. [Home](/) / Mental health Mental health # Mental health and dual diagnosis treatment in Spain A licensed 28-day residential programme in the Málaga countryside, run by an English-speaking team, treating the mental health condition and the addiction in the same house rather than sending each to a different service. Both conditions treated by one team, a price published in full, and no referral fees paid to anyone for sending you here. 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. Sierra Recovery treats mental health conditions alongside addiction in a single 28-day residential programme in the Málaga countryside, published in full at £9,900. Depression, anxiety, trauma, PTSD, burnout and behavioural addictions are worked concurrently with any substance use rather than in sequence, because sending each to a different service is what loses people. Sierra is a registered health centre authorised for addiction healthcare, not a psychiatric hospital: anyone acutely suicidal, acutely psychotic or in crisis is told so at assessment and helped to find the right service instead of being admitted. Below is what is treated, how, and exactly 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 ## Why a rehab has a mental health section Because the separation between the two is administrative rather than clinical. In treatment populations, addiction and mental health conditions co-occur more often than either appears alone, and the reason they get handled by different organisations is funding and history, not evidence. The consequence is well known to anyone who has been through it. The mental health service asks you to come back once you are clean. The addiction service says the psychiatric side is out of scope. Both are acting reasonably within their remit, and the person in the middle gets worse while being told they did not engage. Sierra treats both in one programme, in one house, by one team. That is the whole proposition of this section, and everything below is the detail of how it works and, just as importantly, where it stops. If you are in crisis right nowIn 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. ## What we treat, and where to read about it Condition How it is approached here [Depression](/depression-rehab-spain/) Behavioural activation from the first week rather than rest, with any alcohol use treated at the same time because alcohol is a depressant and works directly against recovery. [Anxiety, panic and OCD](/anxiety-rehab-spain/) Graded exposure and response prevention, because avoidance is what makes anxiety grow. Any benzodiazepine use is tapered under medical supervision first. [Trauma](/trauma-and-addiction-rehab-spain/) Stabilisation, then processing, then reconnection. Nothing forced open, and nothing required to be disclosed in a group. [PTSD and complex PTSD](/ptsd-treatment/) Trauma-focused cognitive work and EMDR where indicated, worked alongside the substance use rather than after it. [Burnout](/burnout-treatment/) Treated as a clinical problem of boundaries, perfectionism and identity rather than as a shortage of rest. [Dual diagnosis](/dual-diagnosis-rehab-spain/) The specific page on treating an addiction and a mental health condition concurrently, and on why sequential treatment loses people. [Behavioural addictions](/behavioural-addictions/) Gambling, gaming and compulsive behaviours, which very often sit on top of depression, anxiety or loneliness. ## 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. The pool and terrace, open through the day Your own private room, included as standard The veranda, where most groups spill out to Cooked by our Michelin-trained chef, three times a day The horses live here, on the land Forty hectares of working farmland, forty five minutes from Malaga [See the full gallery](/facilities/) · [how people get here](/travelling-to-spain-for-treatment/). ## What we are, and what we are not This is the most important section on this page, so it is stated without hedging. 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, authorised for addiction healthcare. It is not a psychiatric hospital, not an inpatient mental health unit, and not a detox unit. We do not detain anyone, we do not provide intensive psychiatric nursing, and we are not a safe setting for someone who is acutely suicidal, acutely psychotic or in psychiatric crisis. Where the assessment shows that, we say so and help you find the right service rather than admitting you. That costs us admissions, and it is the single clearest test of whether a centre abroad is being straight with you. You can [check our registration yourself](/regulation-and-licensing/) on the Junta's public register. Where psychiatric care, diagnosis or prescribing is part of your treatment, it is arranged through the appropriate medical route and coordinated with whoever prescribes for you. We do not start, stop or adjust psychiatric medication ourselves. ### 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. [How admission works](/admissions/) [+44 1202 653136](tel:+441202653136) ## What a day here looks like Structure is a substantial part of the treatment rather than the container for it, because most of these conditions remove 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. 28days, the typical stay 3group sessions a day 17curriculum modules 1986PROMIS method, developed in ## 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. Group work Psychoeducation One-to-one Holistic Equine Aftercare ### 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. That is roughly fifteen structured group contacts a week, which is the part most people underestimate before they arrive and value most afterwards. Groups are small, in English, and run by the clinical team. Hearing someone else describe your own thinking back to you does something that individual work cannot, and it is the fastest route out of the isolation that addiction builds. ### A seventeen-module curriculum, not a rest cure The psychoeducation strand moves through a fixed seventeen-module curriculum written by our clinical director. It is the core of what we call the Regulation Model, which is our adaptation of the PROMIS Clinics methodology to this centre rather than a model of our own invention. It covers skills training, communication styles, boundaries and decision-making, trigger recognition, self-esteem and self-concept, dual diagnosis, self-care and habits, emotions, crisis identification and management, suicide prevention, goals, grief, values, trauma and relapse, perfectionism, loneliness and isolation, and cross-addiction. Every module runs the same structure: check-in, theory, an experiential dynamic, shared reflection, and a commitment carried into the week. 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. It is taught, practised, applied between sessions and reviewed, rather than talked about once. ### Individual therapy alongside the group programme One-to-one sessions run three times a week and are where the material that will not surface in a group gets worked. For most people that is the thing underneath the use rather than the use itself. 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. ### Yoga, meditation and body-based work Saturdays turn to holistic and body-based practice: yoga, meditation and mindfulness, breathwork, art, and time outdoors on the land. This is not decoration and it is not a spa timetable. Early recovery 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 return. The self-care and habits module runs alongside it, treating rest as a right rather than a reward and food as connection rather than control. ### Equine therapy on working farmland The horses live here, on the forty hectares around the house, and equine work is part of the working week. Horses respond to what you are actually feeling rather than what you say you are feeling, which is why the work reaches people who have learned to talk their way around a therapy session. ### 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. For clients elsewhere in Europe we arrange continuity online and help find local services. Alongside that, mutual-aid groups are free, run everywhere, and are worth using whatever else you choose. ## The curriculum, and the mental health modules in it The psychoeducation strand is a seventeen-module curriculum written by our clinical director, and a substantial part of it is mental health rather than addiction content. Module six is dual diagnosis, covering masking, maladaptive behaviour, attachment and somatisation. Module eight is emotions, built on Acceptance and Commitment Therapy. Module nine is crisis identification and management, module ten is suicide prevention, module twelve is grief, module fourteen is trauma and relapse, module fifteen is perfectionism and the inner critic, and module sixteen is loneliness and isolation. The cognitive work throughout uses the ABC model, the structure underpinning cognitive behavioural approaches: the event, the belief you attach to it, and the consequence that follows. It is taught, practised, applied between sessions and reviewed, rather than described once and left. ## Who will actually treat you A small team, in one house, in English. You are not handed between an addiction service and a mental health service, which is the reason this section exists. ### 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](/clinical-team/). ## Treatment options for mental health conditions alongside addiction, 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 Medical detox Required wherever there is physical dependence, and it comes before any reliable psychiatric assessment. Residential rehab inpatient treatment Living at the centre for the whole programme. It suits people whose mental health condition and substance use have each been used as a reason not to treat the other. Outpatient treatment day programmes and therapy sessions Attending sessions and going home between them. The usual starting point, and the right one where the situation is stable and one service will hold the whole case. 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](/dialectical-behaviour-therapy/). EMDR A structured trauma therapy, used where trauma is driving the use and always after stabilisation rather than before it. See [EMDR](/emdr-therapy/). 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](/group-therapy-for-addiction/). 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](/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](/equine-therapy/) and [all our therapies](/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](https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/) Free psychological therapy for anxiety and depression in England, available by self-referral without going through your GP first. [Mind](https://www.mind.org.uk/) Mental health information, advocacy and local services across England and Wales. [Samaritans](https://www.samaritans.org/) 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](https://www.nhs.uk/live-well/addiction-support/drug-addiction-getting-help/) 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](https://www.wearewithyou.org.uk/) Free, confidential support for drug, alcohol and mental health problems, in person in many areas and by webchat. [Adfam](https://adfam.org.uk/) 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. - Get the medical picture togetherCurrent medications, any previous withdrawal, and any diagnosed conditions. This is what the pre-travel assessment needs, and it is what decides whether a detox is required first. - 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. - Bring both historiesEvery psychiatric diagnosis, every medication and dose, every therapy and what happened, alongside the substance history. Assessment is only as good as what it starts from. - Do not stop psychiatric medication to come hereStopping antidepressants or mood stabilisers before assessment is risky and counterproductive. Continuity is arranged through the appropriate medical route. - Say plainly if you are having thoughts of suicideIt does not automatically exclude you, and concealing it is the one thing that could put you somewhere unsafe. ## How Sierra compares with treating each separately at home What you get Sierra Recovery Typical private residential clinic Addiction and mental health treated together One programme, one team, one house Usually two services, two waiting lists, two thresholds 28-day residential programme GBP 9,900, published in full UK GBP 12,000–GBP 40,000 · Australia A$30,000–A$50,000 Being told to come back once you are clean Does not happen here Common Your own private room Included as standard Often an upgrade Referral fees paid to third parties None Common Psychiatric care and prescribing Arranged through the appropriate medical route Varies Written itemised quotation before admission Yes Varies Comparison figures are the published ranges collected on our [cost calculator](/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](/local-treatment-guides/). Indicative, not a quotation. Every clinic sets its own fees. ## What happens after 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 group and a written handover to your GP covering both the addiction work and the psychiatric picture, so prescribing afterwards is managed rather than reconstructed from scratch. For clients elsewhere in Europe we arrange continuity online and help find local services. See [aftercare and discharge](/aftercare-and-discharge/). ## When is it time? If outpatient treatment has stopped moving anything, if getting sober made your mental health worse rather than better, or if you have been passed between services without either treating the whole picture, that is enough. You do not need to be at the worst point you can imagine, and several of these conditions will argue convincingly that you do not deserve treatment. That argument is a symptom. ### 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. [See how admission works](/admissions/) [What £9,900 covers](/pricing/) ## Questions people actually ask Is Sierra a psychiatric hospital? No. Sierra is a registered health centre authorised by the Junta de Andalucía for addiction healthcare, under NICA 67331. It is not a psychiatric hospital, not an inpatient mental health unit and not a detox 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. Do you treat mental health conditions without addiction? The programme is built around addiction and dual diagnosis, so it suits people whose mental health condition sits alongside alcohol or drug use, or who want intensive structured psychological work in a residential setting. Where a condition is severe and there is no substance use at all, a specialist mental health service is likely to fit better, and we will say so at assessment rather than admit you. Which is treated first, the addiction or the mental health condition? Both, concurrently. The only thing that must come first is any medically supervised withdrawal, partly for safety and partly because psychiatric assessment during withdrawal is unreliable: stimulant withdrawal imitates depression and benzodiazepine withdrawal imitates severe anxiety. Can I keep taking my medication? Yes, and you should not stop it to come here. Medication is reviewed and continued through the appropriate medical route, coordinated with whoever prescribes it. We do not start, stop or adjust psychiatric medication ourselves, and a written handover to your GP is part of standard aftercare. What if I am suicidal? Tell us at assessment. It does not automatically mean we cannot help, but it changes 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. 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. How do I get help for a mental health condition alongside addiction? 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. What does a mental health condition alongside addiction 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 residential mental health treatment 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 a mental health condition alongside addiction? The pattern to look for is each condition being used as a reason not to treat the other: told to get clean before the mental health service will see you, and told the psychiatric side is out of scope by the addiction service. Is lasting recovery from a mental health condition alongside addiction 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 residential mental health treatment 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 a mental health condition alongside addiction? 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. + ## 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 [The Regulation Model](/the-regulation-model/)[Assessment & detox](/medical-assessment-and-detox/)[Our programme](/our-programme-at-sierra-recovery/)[Dual diagnosis](/dual-diagnosis-rehab-spain/)[Pricing](/pricing/)[Admissions](/admissions/) --- Source: https://sierrarecoveryspain.com/mental-health-and-dual-diagnosis/ Retrieved: 2026-08-27 Canonical HTML version of this page: https://sierrarecoveryspain.com/mental-health-and-dual-diagnosis/