Abstract
This pilot quasi-experimental trial tested a gender-responsive cognitive behavioral group intervention with 87 court-involved female adolescents (5 juvenile courts) who were at indicated risk for substance use disorder. Participants in the intervention (n = 57) received twice weekly group sessions for 10 weeks (20 sessions) focused on building emotional, thought and behavior regulation skills and generalizing these skills to relationally-based scenarios (GOAL: Girls Only Active Learning). Youth in the control condition (n = 30) received services as usual, which included non-gender-specific aggression management training, individual counseling and no services. The GOAL program was found to be acceptable to youth and parents and feasible to implement within a juvenile court setting using skilled facilitators. Compared to services as usual, the program significantly and meaningfully reduced self-reported delinquent behavior (β = 0.84, p < 0.05) over 6 months, and exhibited trend level effects for reduced substance use (β = 0.40, p = 0.07). The program had mixed or no effects on family conflict and emotion regulation skills. These findings are discussed in light of treatment mechanisms and gender-responsive services.
Highlights
Sustained substance use for females is associated with increased risk for HIV infection, violent victimization and downstream risk for birth defects [1,2,3]
Participants in the two conditions were balanced in age, race/ethnicity and measured baseline characteristics, confirming the design for condition assignment was adequate in balancing observed characteristics
For 3- and 6-month substance use, the mean differences were in the expected direction, and the results showed trend-level effects (p < .10) for generalizing these skills to relationally-based scenarios (GOAL) compared to treatment as usual (TAU)
Summary
Sustained substance use for females is associated with increased risk for HIV infection, violent victimization and downstream risk for birth defects [1,2,3]. Preventing substance use disorders with effective programs for selective and indicated prevention populations can yield substantial savings in avoided medical, system and human costs and are a good investment for social. A cognitive behavioral program for juvenile justice-referred females at risk of substance use and delinquency (https://figshare.com/articles/GOALEvalPlosone_ 1_xls/10022852)
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