Table 1 Orana Haven Treatment Project Logic
a. Client areas of need | b. Intervention | c. Mechanisms of change | d. Process measures | e. Outcomes* | |
|---|---|---|---|---|---|
Core treatment components | Flexible activities | ||||
Primary client areas of need: | Healing through culture and country | - Being on country/spiritualty | Reconnecting clients to culture and country via activities and strong relationships | No. of clients engaged in regular cultural activities | Primary outcomes: |
 1. Risky substance use |  1. Reduced substance misuse (AUDIT* / IRIS* clean urines*) | ||||
- Developing kinships | |||||
- Making artefacts, fishing bush medicine | |||||
 2. Poor quality of life | Case management | - Referrals to local health services and visiting specialists | Clients engaged in the program via positive therapeutic alliance between staff and clients | No. of clients staying in the program for 3 or more mths |  2. Increased quality of life (WHOQoL-BREF*) |
 3. Poor cultural connection | |||||
 3. Increased connection to culture (GEM*) | |||||
- Working with corrections | Referrals to AMS to external health and other social services | No. of Indigenous Health Checks/other referrals | |||
- File notes / assessments | |||||
- Client transport | No. of kms of transport | ||||
Secondary client areas of need: | Therapeutic activities | - One-on-one counselling | Improving client quality of life | No. of clients maintaining abstinence 3Â months post discharge | Secondary outcomes |
 4. Co-occurring mental illness | - AA, morning, psychoeducational groups | Increased understanding of substance misuse (e.g. triggers) and personal strategies (e.g. motivations, goals, timeout) for reducing misuse |  4. Reduced psychological distress (IRIS* / K10*) | ||
 5. Criminal justice involvement | |||||
- Informal counselling | No. of external counselling sessions provided |  5. Reduction in recidivism (Pre/post criminal justice data) | |||
 6. Chronic physical health needs | Life skills | - Develop daily routine | Reconnecting clients to culture and country | No. of vocational-related courses completed |  6. Improved physical health (Pre/post Indigenous health check outcomes) |
 7. Tobacco use | - Positive role-modelling | Relearning daily routine and structure to maintain a healthy lifestyle after discharge | No. of clients achieving individualised life skills goals | ||
 7. Reduction in smoking (RBD Scale* / self-report* / CO levels*) | |||||
 8. Unemployed / limited education | |||||
- Redevelop personal responsibility |  8. Improvement in employment and education (3mth follow-up data) | ||||
- Vocational courses | Learning and developing work-ready and communication skills | ||||
- Literary/ communication skills | |||||
Time out from substances | - Improve physical wellbeing (eg. sleep routine / nutrition) | Identify and engage in positive alternative activities to substance use to learn how to take time out from substance substances | No. of clients engaging in regular exercise / cultural activities | ||
- Improve physical wellbeing (eg. sleep routine / nutrition) | |||||
No. of clients quitting or reducing smoking | |||||
- Smoking cessation | |||||
| Â | - Referrals to services post-discharge (eg. ACCHOs) | Continue to access treatment and care required to maintain improved health and wellbeing post discharge | No. of clients maintaining abstinence/not involved in crime post discharge | ||
- Provide a list of support services in client’s community (eg. AA) | Developing aftercare program post discharge from treatment | ||||
- Ongoing phone contact | |||||