Image: Promises Treatment Center, Malibu and Los Angeles, Calif.
© Promises Treatment Center
Promises in Malibu and L.A., has housed such notable patients like Britney Spears, Ben Affleck, Charlie Sheen, Diana Ross and Matthew Perry. Promises caters to celebrities with 500-thread-count sheets, tennis courts, ocean-side views, fireplaces in private rooms, and a beautician on hand.
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updated 3/31/2008 5:18:47 PM ET 2008-03-31T21:18:47

Even celebrities need a break from the "harsh" realities of everyday life—losing the lead in the latest Hugh Grant rom-com, being unable to afford a second Gulf Stream jet for weekend getaways, failing to evade the paparazzi on a late-night burger run. Maybe that's why so many stars voluntarily commit themselves to rehab centers. But are they truly in need? Or are they going to extremes to avoid the ever-open eye of the media?

"Some may enter a rehab facility as a way to escape public scrutiny, but usually they have some sort of problem as well—even if it isn't related to addiction," says Korin Miller, arts and entertainment editor for amNew York, a daily newspaper in New York City. "However, with the huge wave of celebrities entering and exiting rehab facilities on a regular basis, blaming an embarrassing incident or poor public behavior on an addiction does seem to be an easy excuse. As a result, the public has become skeptical of a star's sincerity when he or she claims to have an addiction problem."

Still, Stacy Kaiser, Los Angeles-based psychotherapist and panelist on the reality TV show "Celebrity Fit Club," maintains that rehabilitation is difficult—if you're rich and famous, or poor and unknown. In fact, having a name worthy of placement on the Hollywood Walk of Fame sometimes makes it even more of a challenge to commit oneself and not fall off the wagon.

"I think it's harder if you're famous, because even though no one's watching you when you're actually in rehab, they are monitoring your progress from the outside," Kaiser says. "If you relapse or end up in rehab four, five, six times, everybody knows about it and that's embarrassing."

As luxe as some may seem, checking into a treatment facility often isn't the first choice for the celebrity who's in trouble. Many, therefore, don't get better—at least, not on the first visit. In fact, many first-timers aren't even trying to get better; they seek treatment to avoid punishment for their wrongdoings.

"You really have to hit your personal bottom in order to get better. Sometimes these celebs are going into rehab simply to avoid going to jail, so they haven't really hit their bottom," Kaiser says. "Or else, they've been dragged in by the law or suggested by their agents or families and don't want to go on their own accord."

Even after "graduating" from a program, it's not uncommon for stars to boomerang back within weeks—sometimes, days. Nancy Wolf, UCLA psychiatrist and psychoanalyst, attributes this in part to the degree of difficulty in cleansing one's life of outside influences once released.

Image: Cirque Lodge, Sundance, Utah
© Cirque Lodge
Located on stunning Mount Timpanogos overlooking Robert Redford's Sundance resort, Cirque Lodge is fully equipped with gyms, saunas, Jacuzzis and media rooms. It captures the essence of a mountain retreat-you may even forget you're not actually on vacation. Perhaps that's why A- and B-listers like Lindsay Lohan, Eva Mendes, Mary-Kate Olsen and Kirsten Dunst have landed at its doorstep.
"For the most part, rehab facilities all provide individual therapy, medication as needed and group therapy," she says. "They try to help their clients develop another lifestyle and ways to deal with the reasons for their addictions. Miracles cannot occur in six weeks, 12 weeks or even six months. The issue really is to provide the safest and best support system for the patient to return to the real world." Treatment often fails when clients return to their previous lifestyle; a drug-free existence may be impossible without vigorous follow-up. "The common misunderstanding," Wolf says, "is that after leaving rehab, the job is done."

Repeat performances are more common among celebrities simply because they can afford to go back. Whereas average people may not necessarily be clean after completing a program, they can't always afford a second stint.

Image: Betty Ford Center, Rancho Mirage, Calif.
© Betty Ford Center
One of the stricter programs out there, this center was founded by the former First Lady tends to attract hardcore clients. The famous alumni include Johnny Cash, Keith Urban, Ozzy Osbourne and Stevie Nicks. Located near Palm Springs and less expensive than most of the other California facilities, Betty Ford costs a mere $24,000 a month.
"If you go back in a second time, it's not like you get a discount, so these celebrities spend hundreds of thousands of dollars on these rehab centers," says Stacy Kaiser. But even some celebrities resent paying a second (or third) time. "They might be fine spending $50,000 at a Louis Vuitton store without a second thought, but they don't want to spend $50,000 on rehab when they think they could get better without it."

Because so many notable treatment facilities are near Hollywood, it's easier than ever for stars to check in and out—as if they were spending time at the Chateau Marmont. Passages, Promises and Wonderland are all within a stone's throw of Beverly Hills, and the world's most renowned center, Betty Ford, is just a couple hours' drive inland in Rancho Mirage. Some California treatment centers will even grant day passes for publicity tours and media events.

Slideshow: Celebrities in rehab "If you're, say, in Arizona, it's harder to do that," Kaiser says.

Other centers, like Eric Clapton-founded Crossroads in Antigua and the favored Meadows in Wickenburg, Arizona, tend to follow the belief that one needs a quiet, relaxed atmosphere in which to get his or her life back on track. These "getaways" come with significant price tags—anywhere from $20,000 to $60,000 per month. But, access to personal trainers, beauticians, world-class chefs and yoga instructors may be part of the package.

Still, don't mistake these treatment centers for resorts. "I don't think celebrities look at rehab as a vacation," says Miller. "Given the chance, they'd probably prefer to go to Mustique or the south of France. After all, some facilities, like Betty Ford, require patients to do chores and stick to a strict schedule. Others may be seen as 'rehab lite,' but it's still rehab."

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