The goal of this project is to evaluate the feasibility, acceptability, and effect size of a new computerized Motivational Enhancement Therapy (cMET) intervention for alcohol-involved adolescents in primary care.

The study aims are to:

1. Assess cMET feasibility and acceptability and estimate its effect size on underage drinking. Hypothesis: Among 14- to 20-yr-old primary care patients, those receiving cMET will have lower rates of any alcohol use, days of alcohol use, drinks per drinking day, and days of heavy episodic drinking, than those receiving treatment as usual.
2. Estimate effect sizes for tobacco, cannabis, and other drug use, and other substance-related risks and outcomes including substance-related driving/riding, and experience of substance-related problems.
3. Identify potential moderators and mediators of cMET's effect.

Inclusion Criteria:

• 14- to 20- yr-olds
• arriving for routine care to one of our participating pediatric practices (Lexington Pediatrics, Lexington, MA; East Boston Community Health Center, Longwood Pediatrics, Tufts Medical Center Adolescent Clinic, Boston, MA; Cambridge Health Alliance Dept. of Pediatrics, Cambridge, MA)
• any alcohol use days in the past 90 days,
• have an email address and internet access at home, school, or library
• provide informed assent/consent.

Exclusion Criteria:

• unable to read or understand English,
• living away at college at the time of the recruitment visit,
• not available for computer/telephone follow-ups,
• judged by the provider to be medically or emotionally unstable at the time of the visit.