Post-therapy follow-up at an addiction centre: denial of responsibility...
A woman struggling with an addiction problem stayed in a specialized treatment centre for a month. Then she agreed to take part in follow-up sessions for her treatment, but she was dissatisfied. She complained about the shortcomings she had noted to the centre's managers. Not receiving a satisfactory reaction from them, she turned to the Québec Ombudsman.
- As soon as her one-month treatment was finished, the woman was offered support sessions as part of what the centre calls post-therapy follow-up.
- The therapist who runs these sessions also practises at the centre as an independent contractor.
- This part of the process, which comes after the month-long treatment, is managed and strongly encouraged by the centre, which takes care of the logistical and financial aspects of the sessions (e.g., lending its premises).
- According to the woman, the therapist's attitude toward her was unacceptable and she committed several ethical breaches, causing the woman real harm.
- When she complained to the centre's authorities, they disclaimed all responsibility, insisting that the woman works as an independent contractor not reporting to the institution for the post-therapy follow-up services she provides.
- The result was that the woman had no recourse for her dissatisfaction in the post-therapy stage.
- The Québec Ombudsman has no jurisdiction to assess the ethical or professional conduct of the independent contractor.
- It does have jurisdiction over the institution, however, and considers its operations in this regard to be unreasonable. Indeed, under a contract between the centre and the independent contractor, the guarantee of quality services disappears completely in the post-therapy treatment that nonetheless takes places on its premises. This appears to the Québec Ombudsman to be a source of conflict of interest that could be potentially harmful for the users.
The Québec Ombudsman's conclusions
The Québec Ombudsman recommended that the centre:
- put an end to its practice of referring clients to private practitioners for follow-up
- inform the Québec Ombudsman of new measures implemented to offer users post-therapy follow-up if required
The centre quickly informed the Québec Ombudsman of its decision to include post-therapy services in the current services of its regular programming. Consequently, this part of the process is now covered by the same quality standards and same recourse options (complaints commissioner, Québec Ombudsman) as the services provided under its residential program.