Country pads and horse therapy for £10k a month but a gruelling treatment schedule… is rehab like a spa or a prison?

At first glance Castle Craig looks every bit the luxurious country house hotel.

Set in 52 acres with beautiful landscaped grounds, inside it’s a vision of homely comfort, with a roaring fire in the main lounge and comfortable en-suite rooms. Plump cushions on the bed only add to the inviting effect.

That, though, is where the resemblance to a relaxing holiday home ends, for Castle Craig is in fact a residential rehabilitation centre for those in the grip of addiction, be it drugs, drink, porn or gambling.

"It’s very far from a health spa," as senior addiction therapist Aureol Gillan puts it: "It’s not a case of come here and have a rest  - it’s come here and work. And it is very hard work.";

It’s this  - or something very like it - that TV star Ant McPartlin is facing after returning to rehab on Wednesday after being arrested for drink-driving at the weekend.

His choice of destination is a private clinic – and in common with all other residential facilities, the hard work will have started from the moment he walked through the front door, however physically comfortable his immediate surroundings.

"About 80 percent of our patients require a medical detox," says Aureol.

"It’s never easy for them but we have on-site consultants and 24 hour medical support to help them through those first difficult days."

Aureol  - a former addict herself - has worked at Castle Craig, which is just outside Peebles in Scotland, for 15 years, and counselled many of the more than 10,000 patients who have stayed there seeking treatment.

The facility take patients from the age of 18, while the oldest are in their 70s, and they come from all walks of life, from builders to businessmen, housewives to household names.

What they have in common is that they’re at rock bottom.

Trappings of success

"Addiction is a great equaliser," as Eytan Alexander, founder of UKAT (UK Addiction Treatment Centres), a string of rehab clinics with premises across the UK says.

"It’s incredibly democratic. We have had celebrities in our centres but their status doesn’t matter – everyone who walks through the front door is in the same position. There’s no hierarchy."

Eytan speaks from experience: a former high-flying financier, he underwent treatment for drink, drug and gambling addiction nine years ago.

"I was lying to everyone for a long time, including myself," he says now.

"I was very successful but the truth was that behind the trappings of success I had a huge problem."

He worked through his problems with the help of Narcotics and Alcohol Anonymous, and has been sober for nine years, but his experience led him to found his own string of rehabilitation clinics.

The cost of treatment

Prices at UKAT’s seven centres start from £5,500 a month, rising to £10,000 a month for the higher end properties, which feature a gym and en-suite rooms.

This is standard fare –  all the 130 residential rehab facilities available in England start from £1000 a week for NHS or local Authority referrals, although according to Aureol these are few and far between these days.

"The people who stayed with us used to be nearly all NHS referrals when we started 30 years ago but they have largely stopped funding now and now people pay privately or through medical insurance," she says.

At Castle Craig a stay costs from £2,835 - £4,375 per week depending on whether the client opts for a multi-occupancy, twin or private room.

This pales in comparison to the cost of celebrity favourite The Meadows in Arizona, where Harvey Weinstein has been treated for sex addiction and which has previously hosted Elle Macpherson.

There, month long residential addiction programmes costs £26,000.

For that you get horseback riding, yoga, meditation and "expressive arts" alongside your intensive therapy, as well as a rather splendid outdoor swimming pool set amid 14 acres of lush manicured grounds.

At Castle Craig, while there’s no horse-riding there is equine-assisted therapy on offer.

"We work with the horses to help learn about behaviours," says Aureol, who owns ten horses which she brings to Castle Craig to help her patients. "They will mirror behaviours back to people."

She acknowledges that the costs of a residential stay are vast  - but points out that the costs of addiction are higher.

"All clinics are expensive because the overheads are huge," she says. "But you have to look at it in the context of how much damage people’s behaviours are causing,"

It’s a sentiment echoed by Eytan. "They are places where people freely come to chose to get help so we make them comfortable  - it’s not a padded cell," he says.

"At the same time all those nice things are not going to get you well – what the money really goes on is paying for treatment.

"It doesn’t achieve anything if you’re in wonderful surroundings with no counsellors."

The power of the group

Most centres follow much the same format: morning meditation followed by group therapy and lectures and later one to one sessions.

In the evening, residents are encouraged to mix with each other over dinner and in the communal areas.

"The group is the most powerful tool in any treatment centre both in terms of group therapy and offering support" says Eytan.

"It is really important as you get challenged by other members and they bring different perspectives."

Recovering addict Danny Wilson, who attended a residential programme at London’s Priory Hospital in 2007, testifies to this, recalling that the pretty accurate cross-section of Britain in his group - among them a journalist, a builder, a barrister, a farmer, an estate agent and a housewife – became "like family" at the end of his month-long stay.

In a searingly honest article he wrote about the reality of his day to day life there, shedding an in sight into what happens in the group sessions.

"Each session kicks off in the same way every day….we go around the room introducing ourselves – 'I'm Danny, I'm an alcoholic and cocaine addict' - and are then asked to describe how we are feeling right here and right now."

"Not how we are thinking or how we were feeling last night or what we may have got up to when off our heads three weeks ago, but how we are feeling right here right now.

"As in happy, sad, angry, bored, horny, frustrated, guilty, suicidal, sometimes all of the above," he recalls.

"It is here, in these daily sessions, where the essence of the Priory programme comes to life.

"Without ever being spelt out in any great detail, what gradually becomes apparent is that the more we can be made to feel and get in touch with these feelings and emotions, then the more likely it is that we can start to deal with them in a constructive manner, rather than trying, as of old, to block them out with a bottle of vodka or a bag of coke."

His description, agrees Eytan, cuts to the heart of what rehab is about.

"I call it the iceberg effect," says Eytan. "Whatever you see above the surface with an addict is a tiny bit of what is really going on below – and the part below is the part we look at in treatment."

Unsurprisingly there are lots of tears along the way.

"We see a lot of raw emotion," adds Aureol. "People talk about things in here that they may never have told anyone, from childhood trauma to difficult relationships.

"At the same time we have people who have started using drink and drugs for fun and it takes over their life.

"The end result is the same  - by the time they get here they always have left a trail of devastation in their wake.";

Ant, of course, has already been in rehab once, so what went wrong?

"Treatment is treatment," says Eytan.

"Recovery starts when you leave and start living in the outside world.

"You have to invest in your recovery as much as you invest in your treatment. If you don’t you are going to slip back into your old ways."

Words that Ant would be wise to heed on the long and difficult days ahead.