Trauma-Informed Program Successfully Reduced Cannabis Use in At-Risk Girls
In a randomized trial of 113 justice- and school-referred girls, a 12-session trauma-informed intervention (VOICES) significantly reduced cannabis use over 9 months compared to an attention control.
Quick Facts
What This Study Found
Girls randomized to VOICES reported significantly less cannabis use over 9-month follow-up compared to the control condition (p<0.01). Both groups showed improvements in psychiatric symptoms and delinquent acts over time, but only VOICES reduced cannabis use specifically.
Key Numbers
113 girls; mean age 15.7; 42% Latinx; 29% justice-referred, 71% school-referred; VOICES (n=51) vs GirlHealth control (n=62); significant reduction in cannabis use in VOICES group (p<0.01); no between-group differences in HIV/STI risk behavior.
How They Did This
Randomized controlled trial comparing VOICES (12-session trauma-informed, gender-responsive intervention, n=51) to GirlHealth attention control (n=62) in 113 girls aged ~15.7 years referred from juvenile justice (29%) and school systems (71%), assessed at baseline, 3, 6, and 9 months.
Why This Research Matters
Girls have unique pathways to substance use that often involve trauma history. This is one of the first trials to demonstrate that a gender-responsive, trauma-informed approach can effectively reduce cannabis use in this underserved population.
The Bigger Picture
The success of a trauma-informed approach suggests that addressing underlying trauma may be more effective for reducing cannabis use in girls than traditional substance use interventions that don't account for gendered pathways to use.
What This Study Doesn't Tell Us
Modest sample size; predominantly Latinx sample from one region; intervention was 12 sessions which may limit scalability; no long-term follow-up beyond 9 months; cannabis use was self-reported.
Questions This Raises
- ?Would VOICES be effective for boys or mixed-gender groups?
- ?Do the cannabis use reductions persist beyond 9 months?
Trust & Context
- Key Stat:
- VOICES significantly reduced cannabis use in girls over 9 months (p<0.01)
- Evidence Grade:
- Randomized controlled trial with adequate follow-up, limited by modest sample size and single-site design.
- Study Age:
- Published in 2021 with 9-month follow-up.
- Original Title:
- VOICES: An efficacious trauma-informed, gender-responsive cannabis use intervention for justice and school-referred girls with lifetime substance use history.
- Published In:
- Drug and alcohol dependence, 228, 108934 (2021)
- Authors:
- Tolou-Shams, Marina(3), Dauria, Emily F(2), Folk, Johanna, Shumway, Martha, Marshall, Brandon D L, Rizzo, Christie J, Messina, Nena, Covington, Stephanie, Haack, Lauren M, Chaffee, Tonya, Brown, Larry K
- Database ID:
- RTHC-03578
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
What is VOICES?
VOICES is a 12-session weekly intervention designed specifically for girls that addresses trauma, substance use, and related risk behaviors through a gender-responsive lens. It was more effective at reducing cannabis use than a general health education control.
Why do girls need different interventions?
Girls often have different pathways to substance use than boys, frequently involving trauma history. This study demonstrated that addressing trauma in a gender-responsive way was more effective at reducing cannabis use than a general approach.
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Cite This Study
https://rethinkthc.com/research/RTHC-03578APA
Tolou-Shams, Marina; Dauria, Emily F; Folk, Johanna; Shumway, Martha; Marshall, Brandon D L; Rizzo, Christie J; Messina, Nena; Covington, Stephanie; Haack, Lauren M; Chaffee, Tonya; Brown, Larry K. (2021). VOICES: An efficacious trauma-informed, gender-responsive cannabis use intervention for justice and school-referred girls with lifetime substance use history.. Drug and alcohol dependence, 228, 108934. https://doi.org/10.1016/j.drugalcdep.2021.108934
MLA
Tolou-Shams, Marina, et al. "VOICES: An efficacious trauma-informed, gender-responsive cannabis use intervention for justice and school-referred girls with lifetime substance use history.." Drug and alcohol dependence, 2021. https://doi.org/10.1016/j.drugalcdep.2021.108934
RethinkTHC
RethinkTHC Research Database. "VOICES: An efficacious trauma-informed, gender-responsive ca..." RTHC-03578. Retrieved from https://rethinkthc.com/research/tolou-shams-2021-voices-an-efficacious-traumainformed
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.