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Table 1 Orana Haven Treatment Project Logic

From: The development of a healing model of care for an Indigenous drug and alcohol residential rehabilitation service: a community-based participatory research approach

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 3 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
  - 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
  1. *Measured at admission, mid, discharge and 3mths post discharge from the OH program
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