Trauma-Informed Program Successfully Reduced Cannabis Use in At-Risk Girls | Research

The takeaway

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.

Juvenile justice programs, gender-responsive intervention developers, adolescent health professionals

VOICES significantly reduced cannabis use in girls over 9 months (p<0.01)

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Randomized controlled trial with adequate follow-up, limited by modest sample size and single-site design.

When this study was published

Published in 2021 with 9-month follow-up.

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.

Questions still open

Would VOICES be effective for boys or mixed-gender groups? Do the cannabis use reductions persist beyond 9 months?

Common 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.

Read the original research

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

View on PubMed ↗Publisher’s paper ↗

Citation

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