The therapies and methods we actually use at Sierra

Clinically reviewed byNerea Encinas SánchezDirector 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.

How a therapy session is structured

Almost every group at Sierra follows the same five-part shape, so you always know where you are and what is being asked of you. This predictability is part of the treatment, not an accident of timetabling. It gives the nervous system somewhere steady to stand while difficult material is worked with.

• Opening, a check-in: a short question to notice how you are arriving, for example “how am I getting to the group today?”
• Introduction, brief theory: a clear, plain piece of psychoeducation on the day’s topic.
• Group dynamic, experiential exploration: an exercise, role-play or piece of creative work that lets you try the idea rather than just hear it.
• Shared reflection, structured dialogue: the group thinks together about what came up.
• Closing and a personal commitment: one small, doable thing to carry into the week.

The curriculum runs across seventeen modules, from communication styles and boundaries through to trauma, grief, values and relapse. It is delivered by our team under clinical director Nerea Encinas Sánchez, a General Health Psychologist, and follows a clinical model adapted from PROMIS Clinics in the UK, who have treated addiction since 1986.

Skills-based psychoeducation: the backbone

The core of the programme is skills-based psychoeducation, a structured intervention that combines clear teaching with practice. Rather than telling you to stop, it trains the specific abilities that make stopping possible, grouped into five families:

• Cognitive skills: restructuring unhelpful thoughts, planning ahead.
• Emotional skills: identifying emotions, regulating them, and building distress tolerance.
• Behavioural skills: problem-solving, impulse control and relapse prevention.
• Social skills: assertiveness, empathy, active listening and conflict resolution.
• Adaptive skills: time management, self-care and asking for help.

These are practised through named exercises you actually do, such as “The Observer Self” for stepping back from an emotion, the “Emotional Traffic Light” for slowing an impulse, and “Protective Boundaries” for saying no. The point is not to do it perfectly. It is to choose differently, even once.

CBT and REBT: the ABC of how thoughts drive feeling

A large part of the cognitive work uses the ABC model, the foundation of Rational Emotive Behaviour Therapy and of cognitive behavioural therapy more broadly. The idea is simple and freeing. It is usually not the situation itself that upsets us, but what we believe about it.

We map real moments onto A, the activating event, B, the belief we tell ourselves, and C, the emotional or behavioural consequence. People often think A causes C. In fact it is B, the belief, that drives C. From there we extend to D, disputing the irrational belief with the group’s help, and E, the healthier response that follows. Learning to catch and question a belief in the moment is one of the most portable skills you take home.

ACT: making room for difficult feelings

Alongside CBT we use Acceptance and Commitment Therapy. Where CBT challenges a thought, ACT changes your relationship to it. Through mindfulness you learn to observe hard thoughts and feelings with curiosity rather than fighting or avoiding them, which is often what the substance was doing for you. At the same time you commit to actions guided by your own values, so daily life starts to feel meaningful rather than merely managed. Self-care at Sierra is built around exactly this, aligning what you do with what matters to you, through work like the “Self-Care Compass”. This ties directly to the module on perfectionism, where we replace the demanding inner critic with a steadier inner ally.

Trauma-informed and attachment-aware work

Because the substance was so often a way of coping with something older, a significant part of the programme is trauma-informed and non-shaming. We look at both overt trauma and the subtler covert, relational kind, such as emotional neglect or growing up in fear, and at how trauma and relapse feed each other in a self-perpetuating loop. This is where our dual diagnosis work sits: masking, the exhausting habit of concealing your true self; maladaptive behaviour as a coping response to an environment that felt unsafe; attachment, the early bonds that shape how safe relationships feel now; and somatisation, the way distress shows up as real physical symptoms. If a mental health condition sits underneath the addiction, it is treated in the same programme rather than referred out. You can read more on trauma and addiction and on dual diagnosis, and the thinking behind all of it on the Regulation Model.

Where someone is physically dependent, any medically supervised detox is completed in an appropriate medical setting before the residential programme begins, and qualified nurses are part of the team throughout the stay. Sierra is a registered health centre in Andalucía, not a hospital or a detox clinic. You can see how assessment works on our assessment and detox page, and how the whole 28-day programme fits together, including what it costs, on pricing and admissions.