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