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PTSD and complex PTSD
PTSD treatment in Spain
A licensed 28-day residential programme in the Málaga countryside, run by an English-speaking team, for post-traumatic stress that is being managed with alcohol or drugs because nothing else has worked.
Both worked in one house by one team, 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.
PTSD is treated at Sierra Recovery alongside the addiction, in one 28-day residential programme in the Málaga countryside published in full at £9,900. The order is stabilisation, then processing, then reconnection: sleep, routine and distress tolerance come first, trauma-focused cognitive work and EMDR follow where they are indicated, and nobody is required to describe what happened or to disclose anything in a group. Sierra is a registered health centre authorised for addiction healthcare, not a specialist PTSD unit, and any medically supervised withdrawal is completed before arrival. Below is what that actually involves 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 PTSD actually is
Post-traumatic stress disorder is what happens when the mind does not finish processing an experience. The memory does not settle into the past as an ordinary memory does. It stays live, and it intrudes: in flashbacks, in dreams, and in reactions to sounds, smells or situations that resemble the original event closely enough for the alarm to fire.
Diagnostically it has four clusters. Intrusion, the memory arriving uninvited. Avoidance, of reminders, places, people and of thinking about it at all. Negative changes in mood and belief, including guilt, shame, numbness and a settled conviction that the world is unsafe or that you are to blame. And alteration in arousal, meaning hypervigilance, startle response, irritability, poor concentration and disrupted sleep. Symptoms lasting more than a month, and getting in the way of living, is the threshold.
Complex PTSD, recognised in ICD-11, adds three further features to that picture: difficulty regulating emotion, a persistently negative sense of self, and difficulty sustaining relationships. It usually follows prolonged or repeated trauma, often beginning in childhood, and it is the presentation we see most often alongside addiction.
PTSD carries a raised risk of self-harm and suicide, and that is a reason for urgency rather than shame. 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.
Why substances and PTSD travel together
Alcohol and drugs are extremely effective at suppressing the four clusters, briefly. Alcohol blunts hyperarousal and forces sleep. Opioids remove emotional pain along with physical pain. Cannabis and ketamine produce distance from a mind that has become unbearable to occupy. Stimulants override the numbness.
Each of them then makes the disorder worse. Alcohol destroys the REM sleep in which memory processing happens, so it directly prevents the mechanism that would otherwise allow the trauma to settle. Withdrawal amplifies hyperarousal. And every substance-assisted avoidance reinforces the avoidance cluster, which is the part that keeps PTSD in place. This is why treating one without the other is not a compromise, it is a plan that does not work.
The signs, as people actually describe them
| What you might notice | Which part of the disorder it belongs to |
|---|---|
| The memory arriving without warning, as though it is happening now | Intrusion. Flashbacks are distinct from remembering, and the difference is the sense of present tense. |
| Avoiding a road, a person, a smell, a conversation | Avoidance. It works in the moment and it maintains the disorder over time. |
| Nightmares, or fighting sleep because of them | Intrusion during sleep. Alcohol suppresses it in the short term and worsens it overall. |
| Scanning rooms, sitting facing the door, jumping at sounds | Hyperarousal. The nervous system has not been told the danger has passed. |
| Believing it was your fault, or that you should have done something differently | Negative alteration in belief. It is a symptom, not an assessment, and it responds to treatment. |
| Feeling nothing much at all, for anyone | Numbing. Often mistaken by families for indifference when it is the opposite. |
| Drinking or using specifically to sleep, or to stop thinking | The overlap. It is the single most common reason PTSD arrives in an addiction service rather than a mental health one. |
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
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 a specialist PTSD inpatient unit.
We treat PTSD as it presents alongside addiction, which is how it most often presents, and we do it inside a residential programme rather than as a standalone trauma service. If PTSD is your primary diagnosis and there is no substance use, a specialist trauma service is likely to fit you better and we will say so at assessment. If you are acutely at risk, a residential centre abroad is not the right setting and we will say that too. You can check our registration yourself on the Junta's public register.
Where 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 specialist trauma service would serve you better.
What a day here looks like
Predictability is not a background detail in PTSD treatment. A nervous system braced for threat settles faster in an environment where nothing is unannounced. 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.
Safety and regulation come first
Sleep, food, routine, and the skills to tolerate distress without a substance. Grounding, breathwork and the emotions and crisis-management modules. For a month-long stay this is the centre of gravity and it is not a preliminary.
Processing trauma before stabilisation is in place makes people worse, which is why the order is not negotiable.
Working with the memory itself
Trauma-focused cognitive work on the beliefs the event installed, and EMDR where it is clinically indicated. This happens in individual sessions, at a pace you set.
Nobody is required to give an account of what happened, and nothing is processed in an open group. See EMDR.
Three group sessions a day, five days a week
Process group at 10:30, therapeutic group at midday, psychoeducation after lunch, an activity in the afternoon and the day closing together.
Groups work on the present: shame, isolation, relationships and the patterns the trauma set up. The event itself is worked one to one.
The part that changes first
Fixed hours, daylight, activity outdoors, yoga and breathwork. Alcohol suppresses REM sleep and therefore blocks the processing that would let a memory settle, so sober sleep is itself part of the treatment.
Nightmares often intensify briefly when drinking stops and then improve, and knowing that in advance stops it being read as deterioration.
Reconnection
The boundaries, communication, values and loneliness modules, plus family work where it is wanted. Complex PTSD damages relationships in specific, learnable ways, and those are workable.
What happens when you go home
Planned before you leave. 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 trauma work and the addiction work.
Who will actually treat you
A small team, in one house, in English. Continuity matters more in trauma work than in any other kind, 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.
Treatment options for PTSD, 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 stabilisation comes before any trauma processing. |
| Residential rehab inpatient treatment | Living at the centre for the whole programme. It suits post-traumatic stress that is being managed with alcohol or drugs, where treating either alone has not held. |
| Outpatient treatment day programmes and therapy sessions | Attending sessions and going home between them. The usual starting point. Trauma-focused CBT and EMDR are available through NHS talking therapies. |
| 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.
- 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.
- You do not have to write an account of itThere is no requirement to disclose detail to be admitted, and none to disclose it in a group at any point. Saying that something happened is enough to start.
- Bring what has been triedPrevious therapy, what helped, what made things worse, any diagnosis and any medication. What went badly before is as useful to know as what went well.
How Sierra compares with treating each separately at home
| What you get | Sierra Recovery | Typical private residential clinic |
|---|---|---|
| PTSD and addiction treated together | One programme, one team, one house | Usually two services, and trauma work often deferred until abstinent |
| 28-day residential programme | GBP 9,900, published in full | UK GBP 12,000–GBP 40,000 · Australia A$30,000–A$50,000 |
| Required to disclose in a group | No, never | Varies |
| Your own private room | Included as standard | Often an upgrade |
| Referral fees paid to third parties | None | Common |
| Continuity of therapist through the stay | Same small team throughout | Often rotates |
| Written itemised quotation before admission | Yes | Varies |
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 is it time?
If you are drinking or using to sleep, if the memory still arrives in the present tense, or if you have been told to sort out the substance use before anyone will treat the trauma, that is enough. PTSD does not resolve by being left alone, and the strategies that make it survivable in the short term are the ones that keep it in place. See also trauma and addiction and dual diagnosis.
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
Can PTSD be treated at the same time as addiction?
Yes, and it should be. Treating the addiction first and deferring the trauma removes the coping strategy while leaving the disorder intact, which is why relapse so often follows a few months into abstinence. What comes first is stabilisation, meaning sleep, routine, safety and distress tolerance, alongside any medically supervised withdrawal. Processing follows that.
Will I have to describe what happened?
No. Nobody is required to give an account of their trauma to be admitted or at any point during the stay. Processing work happens in individual sessions at a pace you set, never in an open group, and a considerable amount of effective treatment involves no detailed retelling at all.
What is complex PTSD?
Complex PTSD is recognised in ICD-11 and adds three features to the standard picture: persistent difficulty regulating emotion, a persistently negative sense of self, and difficulty sustaining relationships. It usually follows prolonged or repeated trauma, often starting in childhood, and it is the presentation most commonly seen alongside addiction.
Do you offer EMDR?
EMDR is used where it is clinically indicated, within a stabilisation-first sequence rather than as a standalone product, alongside trauma-focused cognitive work and body-based practice. Our EMDR page explains how it fits into the programme.
Is Sierra a specialist PTSD unit?
No. Sierra is a registered health centre authorised for addiction healthcare, and PTSD is treated here as it presents alongside substance use. Where PTSD is the primary diagnosis with no substance use, or where someone is acutely at risk, a specialist service is the right answer and we will say so at assessment rather than admit you.
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 PTSD?
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. Trauma-focused CBT and EMDR are available free through NHS talking therapies in England.
What does PTSD 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 PTSD 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 PTSD?
The symptoms of PTSD fall into four clusters: intrusion, meaning flashbacks and nightmares; avoidance of reminders; negative changes in mood and belief, including guilt and shame; and hyperarousal, meaning hypervigilance, startle response and disrupted sleep. Lasting more than a month and getting in the way of living is the threshold.
Is lasting recovery from PTSD 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 PTSD 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 PTSD?
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.
