gender-responsive drug use treatment for juvenile justice girls

Conditions: Drug Use

Summary: girls in the juvenile justice system have unique developmental pathways to drug use and co-occurring risk (e.g., hiv/sti) behaviors that have typically not been considered or tested in order to identify evidence-based gender-specific substance use treatment approaches for this population. this study will advance scientific knowledge and clinical practice in the drug treatment and public health fields by testing the efficacy of a pre-existing, widely disseminated gender-responsive substance use treatment (voices) on drug use and hiv/sti risk behavior outcomes for a broad range of substance using girls and young women (ages 12-24) who are at-risk for or already involved with the justice system.

compared to both non-offending females and male offending counterparts, offending girls are at significantly greater risk for the development of substance use disorders, psychiatric symptoms and negative health outcomes, such as hiv/aids or other sexually transmitted infections (stis). research suggests that girls may have different developmental pathways to drug use, initial legal involvement and co-occurring negative health outcomes that support the importance of testing gender-specific treatments for juvenile justice girls. although there is recent increased emphasis on gender-specific programming in juvenile justice, empirically supported gender specific interventions to improve health, mental health and/or legal outcomes among juvenile justice girls are lacking. the objective of this stage ii treatment trial is therefore to test the efficacy of a pre-existing, widely disseminated gender-responsive drug use treatment (voices) among 130 girls who are at-risk for or already involved with the justice system. we seek to test the effect of voices on girls' drug and alcohol use, hiv/sti risk, psychiatric symptoms and recidivism as well as explore moderators and mediators of outcomes. girls and young women, ages 12-24 (n= 6 juveniles for phase i intervention run-through; n=130 for phase ii rct study) will be recruited from justice partners (probation, diversion programs) and school partners (high schools/middle schools). participants will be randomized to either the voices (active) intervention (n=65) or a girl health (attention control) condition (n=65). in phase i (first six months of year 1), 6 juveniles will be recruited to complete the intervention run-through and research assessment once to allow testing of rct intervention and assessment procedures prior to the rct phase. in phase ii (last half of year 1 through year 4), 130 girls will be recruited and randomized at baseline and then re-assessed at mid-treatment, end of treatment, 3 months and 6 months post-intervention. biological specimens for juvenile drug use will also be collected at each 3-month assessment. efficacy trial results can be used to make immediate changes to current widespread program delivery resulting in direct impact on the field of evidence-based gender-responsive substance use interventions for juvenile justice girls and young women.

Eligibility criteria:
inclusion criteria: 130 court-involved, non-incarcerated (cini) female juvenile offenders or those at-risk for court-involvement, ages 12-24, who report any alcohol, marijuana or other drug use in the past 90 days will be eligible for enrollment with the following criteria: 1) determined to be in need of substance use treatment by the court intake worker, probation officer, presiding judge or magistrate, and/or school counselor; 2) legal guardian available to consent for child's participation, if the child is under the age of 18, and 3) child is english speaking. exclusion criteria: 1. meet dsm-v criteria for substance use disorder with current severity rating of severe (6 or more symptoms) (as determined through referral partner); 2. already in substance use treatment (residential or outpatient) and wish to remain with outside provider (as determined through referral partner); 3. observable cognitive or developmental delays or active psychosis that would interfere with completing consent, assessment or intervention.

Keywords: adolescent juvenile justice drug use marijuana gender responsive girls hiv sexual risk