How we score

The ten criteria

1. C1. Client separation and occupancy

   Will I, or my relative, ever meet another client, or be seen by one, from arrival to discharge?

   C1 separates three things clinics often blur: one-to-one therapy, a residence of your own, and a guarantee that clients never meet. Shared bedrooms as the standard room score 1. Private rooms with a daily group programme score 3 to 5, depending on how many clients are on site (more than 20, 20 or fewer, 10 or fewer) and whether the clinic has a confidentiality measure beyond what the law requires. No group therapy but a shared residence or shared facilities scores 6 or 7. One client per residence scores 8. Band 9 needs an established no-contact model: one client per residence, no group therapy, an explicit statement that clients never meet, no shared facility (or scheduling that keeps clients apart in every one), individual transport and at least two named confidentiality measures. Band 10 adds confirmation from an official record or independent first-hand reporting, with no contradiction.

   One-to-one therapy on its own caps C1 at 7. One client per residence without an established no-contact model caps it at 8. A separately priced sole-occupancy option adds at most 1 point to the standard offer, never above 8. Each contradiction in the clinic's own statements about its separation model costs 1 point, up to 2. Client numbers are used only for the thresholds above: a full clinic is not a worse clinic. With nothing published, C1 is 3 or lower.

2. C2. Clinical governance and medical cover

   Is this a licensed treatment facility, is a doctor accountable for my care there, and is a physician reachable at night and in an emergency?

   C2 checks eight things at this site: a licence on an official register in a category that covers the service (G1); a physician named as accountable for clinical governance, such as a medical director or lead psychiatrist (G2); 24-hour physician or psychiatrist cover, on site or on call, as part of the standard offer (G3); medically managed withdrawal on site (G4); general medical care by a physician, such as cardiology or endocrinology (G5); a hospital licence or an escalation route to a named hospital (G6); current accreditation by an accrediting body, shown on its own register (G7); and defined programmes for complex psychiatry that the clinic treats rather than refers out (G8).

   Without a licence found on a register (G1), C2 cannot go above 5. With G1 and G2, the band depends on how many of G3 to G8 are met: one gives 6, three give 7, four give 8, five including G3 and G6 give 9, all six give 10. A clinic's own statement of its licence never counts for G1. A night doctor available only at extra charge, nursing cover or an unnamed "medical team" do not count as G3. With nothing published about medical staffing, C2 is 1.

3. C3. Diagnostic depth on admission

   Before and when I arrive, will clinicians properly assess what I have, mentally and physically, so that treatment fits me?

   C3 counts eight assessment elements: clinical screening before you commit (E1), a psychiatric assessment by a psychiatrist (E2), medication review by a physician (E3), a laboratory panel (E4), a physical examination by a physician (E5), at least one specialist diagnostic such as imaging, a cardiac work-up or neuropsychological testing (E6), a written multidisciplinary formulation or diagnostic report given to the client (E7), and a standalone diagnostic assessment with a stated duration (E8).

   One to three elements give 3 to 5. Band 6 needs four including E2; band 7 five including E2 and E4; band 8 six including E2, E4 and E5; band 9 seven including E6 and E7; band 10 all eight. An intake call, form or questionnaire handled by admissions staff scores 2, and an online self-assessment never counts as a diagnosis. An element delivered by a psychiatrist or physician counts only if the clinic names such a clinician for this site or is hospital-licensed. With nothing published, C3 is 1.

4. C4. Clinical intensity

   How much one-to-one time with clinicians will I actually get each day, and is the team mine or shared with many others?

   C4 measures one-to-one time with a psychiatrist, physician, psychologist, psychotherapist or counsellor. Coaching, fitness, massage, complementary therapy and hotel time do not count, and hours a team is merely present are not contact hours. Sessions per week set bands 2 to 5. From band 6 the clinic needs a typical or minimum daily figure: at least 1.5 hours a day gives 6, 3 hours gives 7, 4 hours with a dedicated clinical team gives 8, and 6 hours with a dedicated team and a clinician present in the residence around the clock gives 9. Band 10 adds confirmation of the hours or the team from an official record or independent first-hand reporting, and a sample daily or weekly schedule.

   A dedicated team means the treating clinicians carry no other residential client during your stay. Round-the-clock presence counts only when a clinician lives in with the client or stays overnight in the client's own residence. Counting rules: "up to X hours" counts as half of X unless a typical or minimum figure is also given, a range counts at its lower end, and a session with no stated length counts as 50 minutes. A fixed package length with no extension on clinical grounds caps C4 at 6. If more than half of clinical hours are in groups, the cap is 6; more than three quarters, the cap is 4. Individual therapy offered with no count scores 3; not mentioned at all, 1.

5. C5. Continuity and aftercare

   What happens after I leave: who looks after me, for how long, and at what cost?

   C5 counts ten aftercare elements: a written plan made before discharge (A1), a stated duration or minimum (A2), aftercare included in the fee or with a stated price (A3), delivery by the same team or operator (A4), psychiatric review or medication management (A5), an in-person option at home or a step-down within the operator (A6), family involvement (A7), coordination with your own doctors (A8), structured clinician-led contact for at least six months (A9), and remote sessions (A10).

   One or two elements give 3, then each further element adds a band up to 6 (five elements). Band 7 needs six including A2; band 8 seven including A2 and A4; band 9 eight including A2, A4, A5 and A9; band 10 nine or more including A2, A4, A5, A6 and A9. "As long as needed" is not a duration. Alumni events, a newsletter or an app do not count as structured aftercare on their own. Aftercare named with no detail scores 2; nothing published, 1.

6. C6. Admission integrity and commercial conduct

   Is this clinic honest about its price and how it wins clients, and will it turn me away or refer me on if it is not right for me?

   C6 starts with a recorded sweep of every domain the clinic or its group runs. Three things are violations: a "best" or "top" ranking on a site the clinic or its group controls that includes the clinic or a sister clinic (V1); paid, sponsored or invented recognition presented as independent (V2); and content written to steer AI assistants or search tools towards the clinic (V3). Four things are positive signals: a specific residential price published on the clinic's own site and not described as negotiable (P1); a published position on referral fees (P2); a stated policy that unsuitable admissions are declined or referred elsewhere (P3); and a stated policy that admission is voluntary, including when a family or employer arranges it (P4).

   A clean sweep with no positive signal scores exactly 4. A clean sweep with one to four positive signals scores 5 to 8. Band 9 needs all four signals, with P2 met by a policy that the clinic neither pays nor receives referral fees. Band 10 adds confirmation of P2, P3 or P4 from an official record or independent first-hand reporting. One violation gives 3, or 4 with three or more positive signals. Two or more violations give 2, or 1 if one of them is V3. A statement from the clinic never clears a violation the sweep found.

7. C7. Transparency toward the client

   Before I pay, can I check what the fee covers, what happens if I leave early, who really owns the clinic, and how I can complain?

   C7 scores what the clinic's own site lets you check before paying, across ten elements: what the fee includes and excludes (T1); payment, deposit, cancellation or refund terms (T2); fee terms for extending the stay or leaving early (T3); the licence or accreditation with a number or register link (T4); the legal operator with a company number or registered address (T5); ownership and group structure, consistent with company registers and audited accounts (T6); a complaints procedure naming at least one outside body (T7); published inspection results (T8); a privacy notice naming the data controller and how long client records are kept (T9); and a candid statement of limits, such as conditions not treated (T10).

   Each element met adds a band, from 1 (none) upwards. Band 6 needs five including T1; band 7 six including T1 and T2; band 8 seven including T1, T2 and T6; band 9 eight including T1, T2, T4 and T6; band 10 nine or more including those four, with no contradiction deducted. Each contradiction, such as two of the clinic's pages giving different fees or an ownership statement that official records contradict, costs 1 point, up to 3. Stale price pages count as one contradiction in total. Terms given only on request or only after a deposit do not count. A site that publishes only programme descriptions scores 2 or lower.

8. C8. Track record and regulator standing

   Has any regulator or court found against this clinic, and has anyone independent inspected or visited it recently?

   C8 counts only final outcomes. Allegations, open investigations and pending cases score nothing. Findings are graded by severity: critical (such as a closure order or licence revocation), serious (such as a fine, conditions on registration, or a finding that care failures contributed to a death or serious harm) and moderate (such as a requirement notice or a final finding on referral fees or deceptive marketing). A critical finding in the last 5 years gives 1. Older or less severe findings give 2 to 5, depending on their age and on whether a good inspection followed.

   With no finding in the last 10 years, the band depends on standing: an inspection by a statutory regulator in the last 5 years (S1); a regulator inspection in the last 3 years graded good or better, or with no requirements (S2); independent bylined first-hand reporting from inside the clinic in the last 5 years with no adverse finding (S3); and verifiable client testimony (S4). No finding and none of these gives 5. A site with no inspection on record can reach 6 at most. S1 plus one, two or all three of S2 to S4 gives 7, 8 or 9. Band 10 also needs the good inspection to be within 2 years and no critical or serious finding at any date. Findings follow the clinic through a rename, new legal entity, change of operator or move within the last 5 years. Years in operation never score.

9. C9. Environment, safety and nutrition

   Is the place physically safe for someone in crisis, close to emergency care, and does it treat food as part of treatment?

   C9 is the average of two sub-scores, rounded half up (6.5 becomes 7). Environment and safety counts nine elements: a therapy room on site (H1), outdoor or exercise space (H2), a hospital emergency department within 30 minutes by road, with the travel time sourced (H3), resuscitation equipment and trained staff (H4), an alcohol-free residence and a medication policy (H5), a self-harm risk assessment of the residence (H6), named residence staff roles (H7), arrangements for family visits (H8), and independent proof that the premises shown are the real ones (H9). Bands 6 to 9 of this sub-score need H3, then H4, H5 and H9 in turn.

   Nutrition counts eight elements, led by a named nutrition professional with a regulated or degree-level qualification (N1), then an assessment, a plan built from the client's own clinical data, a kitchen that works to that plan, dietary accommodations, education, condition-specific protocols and monitoring. Without N1 the nutrition sub-score is capped at 5; with only an unregulated nutrition credential, at 7. Scenery, climate, luxury finishes, activities and chef credentials never score, and stock photos are never evidence of the premises.

10. C10. Clinical seniority and academic standing

    Who will actually treat me, and can their qualifications and standing be checked on official registers and university pages?

    C10 counts only named people with a role on client care or clinical governance at this site, whose credentials an official register, university page, academy or prize body confirms, in a field relevant to mental health and addiction. Credentials are weighted by level (from registered health professional through specialist, university appointment and distinguished honours), by how involved the person is at this site and by how relevant their field is. They are combined into a Clinical Seniority Index that reflects the depth of the team, its size relative to the number of clients, and the most senior person on client care.

    Gates set the ceiling. Band 5 and above needs a relevant specialist working on cases. Band 7 and above needs a specialist in a relevant field leading clinical governance. Band 8 and above needs a university-appointed clinician on cases, not only a regular consultant. Band 9 and above needs a senior academic (associate professor, Privatdozent or higher) at full involvement. Band 10 needs two such people, or one holder of distinguished honours. Advisory and board members count at a quarter weight, or at full weight when they speak about the clinic in the clinic's own video and four set conditions are met. Unnamed headcounts ("over 30 experts"), first-name-only rosters and titles that do not match the register never count. Only the C10 points are published: the index itself, and anything from which a clinic's capacity could be worked out, is not. With no verifiable roster, C10 is 1.

Ties and order on the page

When something is not published

Sealed evidence

Editions and how the rules change

What our labels mean