Web-based CBT for Recent Veterans Experiencing Problems With Trauma Symptoms or Alcohol/Drug Use

Phase 1: Focus Groups Inclusion Criteria: 1. At least 18 years of age 2. An OEF or OIF veteran (verified via CPRS) 3. Screen positive on the Audit-C (\>=3 for women or \>= 4 for men) OR screen positive on the PC-PTSD (\>=3). 4. Currently receiving primary medical care at a VA Medical Center (verified via CPRS) Exclusion Criteria: 1. Insufficient ability to understand or provide informed consent 2. Lack sufficient ability to use English to participate in the consent process, 3. Current plan or intent to harm themselves as measured with the suicide assessment in Appendix D after the consent process. Phase 2: Feedback Sessions Inclusion Criteria 1. At least 18 years of age 2. An OEF or OIF veteran (verified via CPRS) 3. Hazardous or harmful substance use as measured by one of the following: * AUDIT-C score of \>=3 (for women) or \>= 4 (for men) OR * DAST score of \>=2 OR * Have exited a controlled environment (e.g., detoxification unit, hospital, or correctional facility) within 30 days of screening AND within 30 days prior to entering the controlled environment report: i. heavy drinking (\>3 drinks for women or \> 4 drinks for men on one or more days), or ii.use of any illegal drugs, iii.or misuse of prescription drugs (use in excess of the directions or any non-medical use) 4. Screen positive on the PC-PTSD (\>=2). 5. Currently receiving primary medical care at a VA Medical Center (verified via CPRS) Exclusion Criteria: 1. Insufficient ability to understand or provide informed consent 2. Lack sufficient ability to use English to participate in the consent process, the computerized intervention or the assessments. 3. Current plan or intent to harm themselves as measured with the suicide assessment in Appendix D administered after the consent process. Phase 3: Randomized Clinical Trial Inclusion Criteria: 1. At least 18 years of age 2. An OEF or OIF veteran (verified via CPRS) 3. Hazardous or harmful substance use as measured by one of the following: * AUDIT score of \>=7 (for women) or \>= 8 (for men) OR * DAST score of \>=2 OR * Have exited a controlled environment (e.g., detoxification unit, hospital, or correctional facility) within 30 days of screening AND within 30 days prior to entering the controlled environment report: i. heavy drinking (\>3 drinks for women or \> 4 drinks for men on1 or more days) or ii. use of any illegal drugs iii. misuse of prescription drugs (use in excess of the directions or any non-medical use) 4. Determined to have diagnostic-level or PTSD (1 A symptom, 1 B symptom, 3 C symptoms AND 2 D symptoms) or subthreshold PTSD (1 A symptom, 1 B symptom, 3 C symptoms OR 2 D symptoms) on the Clinician Administered PTSD Scale (CAPS). 5. Currently receiving primary medical care at a VA Medical Center (verified via CPRS) Exclusion Criteria: 1. Plans to move out of area within the next three months 2. Currently enrolled in a substance abuse treatment program or receiving treatment for PTSD from a mental health professional (verified via CPRS). 3. Insufficient ability to understand or provide informed consent 4. Lack sufficient ability to use English to participate in the consent process, the computerized intervention or the assessments. 5. In need of alcohol detoxification as determined by a score of \> 15 on the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar). 6. Current plan or intent to harm themselves as measured with the suicide assessment in Appendix D administered after the consent process. 7. Medical chart diagnosis of a current psychotic disorder, including schizophrenia or bi-polar disorder 8. Cognitive impairment specified by a medical chart diagnosis. Diagnoses include dementia and moderate to severe traumatic brain injury (TBI). Patients with mild TBI will not be excluded. The Second Level TBI Assessment present in patient medical records can be used to verify the severity of TBI.