The main sources of information for the study were: 1) an international literature review on adolescent drug abuse and treatment outcome research (e.g., aetiology of substance abuse and best practices - what has proved effective?); 2) consultations with service providers (street-work, drop-in centres, health, accommodation and drug treatment services); and 3) consultation with adolescent substance abusers through personal interviews, group discussions and a self-completion questionnaire. The research suggested that:

• drug abuse is part of a problem behaviour syndrome; adolescent drug abusers tend to have multiple problems, such as health, legal, accommodation and social problems
• high stress levels, poor coping skills and lack of social support have been associated with adolescent substance abuse
• family relationships affect substance use behaviour (e.g., inconsistent discipline, family involvement in substance abuse and crime and negative communication patterns)
• reducing risk factors is not sufficient for changing drug use behaviours, protective factors need to facilitated
• interventions that include family involvement, teaching clients skills and increasing social support have been found to have positive outcomes (e.g., reduced problematic substance use).
• PALM's goal, operational principles, objectives and strategies were based upon the research findings and resulted in a comprehensive or "holistic" programme plan which includes:
• case-management (assessment, case planning and monitoring, linking clients to other services, advocacy and support)
• group education and training (knowledge of harm reduction; skills training related to decision-making, problem solving, relaxation, anger management and conflict resolution, communication, assertiveness and relapse prevention)
• family work (parenting skills development; family therapy; parent support groups;
• family days)
• counselling (problem-management approach)
• ecreation (art, sport)
• after-care groups (case management, support/social groups, progress review groups).

Participation in PALM by the adolescents is voluntary but most are referred via the Department of Juvenile Justice. While residents can leave the programme at any time, there are generally consequences, such as receiving a harsher sentence when their case is heard in court, having to go into detention after receiving a court sentence or being expelled from the home if parents will only accept them back after they have done a drug treatment programme.

HIV prevention is incorporated in PALM's programme through a harm reduction approach. The adolescents are helped to identify and work towards their own goals. If they want help to abstain from drug use, they receive help to achieve that goal. If they want to change their drug use to be less risky or harmful, they are helped to achieve that goal.

It is acknowledged that people are likely to relapse so the participants are prepared for this likelihood and how to reduce the riskiness of lapses. For example, the following question is explored: if you do slip, what harms are you risking and how can you prevent or reduce them? For some clients, unsafe sex might be the likely consequence of a lapse, for others there might be a risk of unsafe injecting practices. The adolescents then work on generating their own, appropriate and acceptable strategies for preventing or dealing with those possible risks.

When the youth go on weekend leave (in the latter stages of the programme), they have an opportunity to experience the temptations and issues that they have been protected from while in the programme. They then re-examine their goals and strategies when they return.

To complement the goal-setting activities mentioned above, PALM has a health education component, including HIV/AIDS risk education, and a personal skills training component to help the adolescents implement their plans. For example, if a strategy for preventing unsafe sex is to use a condom, assertiveness might be required to implement that strategy.

Finally, although the youth are not permitted to engage in sexual activity while they are in the residential programme, condoms are easily available (in the bathroom cabinet) and information about where to obtain injecting equipment is included in a pack when clients leave.