To date, brief interventions (BI’s) are among the most empirically supported individual level interventions for reducing alcohol use and alcohol-related problems in adolescents [
25,
26]. They are often based on principles of Motivational Interviewing (MI) [
27], which is characterized by an empathic approach to the client and a non-judgemental and non-confrontative counseling style [
28]. Such short-term preventive or therapeutic interventions usually span one to three sessions [
29,
30] with the goal to establish and support intrinsic motivation for behavior change and/or further treatment seeking [
31]. A comprehensive body of evidence documents the usefulness of BI’s for problematic alcohol use in primary care [
32] and general hospitals [
29]. The emergency department (ED) has been identified as a feasible setting to implement early interventions for problematic alcohol use [
33,
34] and efficacy of BI’s in ED has attracted a substantial body of research [
35‐
37]. However, with few exceptions [
4,
38‐
41] to date adolescents have been only sparsely addressed [
42,
43]. None the less a small number of studies indicate feasibility and effectiveness of BI’s for adolescents in an ED following an
alcohol-related event such as alcohol-induced injury [
38‐
40]. While these studies vary substantially in key conceptual and methodological issues and the heterogeneity of findings limits generalization [Diestelkamp SD, Drechsel M, Arnaud N, Thomasius R:
Brief Interventions for Alcohol-involved Adolescents in Emergency Care: A Systematic Review, forthcoming] [
43], these studies are informative because they support the notion that alcohol-related events causing hospitalization are associated with a “teachable moment” that opens a window of opportunity for effective intervention [
44‐
46]. The experience of a potentially life-threatening AAI resulting in hospitalization supposedly leaves adolescents in a state of increased responsiveness to alcohol-related counseling [
46,
47]. While awareness of alcohol having prompted ED hospitalization generally influences BI outcomes [
45], there is currently a lack of studies addressing the potentials of BI’s following AAI hospitalization. Given the articulated need for indicated preventive interventions for AAI we build on the current empirical and conceptual base for BI’s in this context as well as our own favourable pilot results for feasibility and initial effectiveness in this context [
4]. In this study protocol we present the design and current implementation of a randomized-controlled trial that aims at evaluating effectiveness of a manualized brief motivational intervention (BMI) (indicated intervention) for children and adolescents who are being treated in the ED immediately following AAI, an approach that has been established in Germany and other European countries [
48‐
50] over the last 10 years (see below) but has not been rigorously tested to date. Moreover, we include additional evaluative components to address practical conditions within the “real-world” ED-setting that might affect effectiveness and implementation [
51,
52].