About

Melissa Pielech, PhD, is an Assistant Professor of Behavioral and Social Sciences and Psychiatry and Human Behavior at Brown University. She is a clinical researcher and pediatric psychologist dedicated to improving the lives of youth using substances and/or experiencing pain by increasing access to evidence-based treatments for pain and substance use within pediatric integrated care settings. Her research focuses on understanding the relationship between pain and substance use behaviors in youth through innovative methodologies such as ecological momentary assessment, and on developing and evaluating patient-centered interventions that address both pain and substance use. She also works on addressing barriers to family involvement in youth opioid and substance use disorder treatment, improving opioid stewardship in pediatric care, and increasing the integration of substance use screening and treatment in pediatric settings via provider training. Dr. Pielech has built a multidisciplinary, collaborative research program guided by the needs of patients, families, providers, and clinics, emphasizing patient and family engagement in research design and dissemination. She is a licensed clinical psychologist providing clinical services to youth with persistent pain and somatic symptoms at Hasbro Children's Hospital and serves as a research mentor and clinical supervisor for pediatric psychology residents at Brown University.

Research topics

• Medicine
• Internal medicine
• Intensive care medicine
• Psychiatry
• Emergency medicine
• Demography

Selected publications

• Pediatric Oncology Providers’ Perceptions on Pain Management and Opioid Use for Adolescents and Young Adults With Cancer: A Qualitative Study

  Pediatric Blood & Cancer · 2026-01-16

  article

  BACKGROUND: Over 89,000 adolescents and young adults (AYAs) are diagnosed with cancer every year in the United States, and despite high survival rates, AYAs continue to experience the late effects of cancer and its treatments into survivorship. Pain, cited as the most distressing, impairing, and undertreated symptom during and after active treatment, is a common concern for AYAs with cancer and a challenge for oncology providers to manage. First-line pain treatments often include prescription opioids, but there is limited evidence to support the efficacy of long-term opioid use to manage pain among AYAs, along with increased risk of opioid-related negative consequences. Given the relative lack of research in this area, there is an opportunity to better understand how oncology providers think about and navigate chronic pain management and mitigate risk for opioid-related negative outcomes. METHOD: Therefore, we conducted a semi-structured qualitative study with 14 pediatric oncology providers, assessing current pain management practices, decision-making, attitudes and perspectives, and challenges to providing safe and effective pain management for AYA oncology patients. Interviews were summarized using a Rapid Qualitative Analysis framework. RESULTS: Results provided support for three themes: perceptions about pain and pain management needs for AYAs with cancer; pharmacological and nonpharmacological treatments for cancer-related pain; and education, standardization, and challenges of opioid pain management. CONCLUSIONS: There are a number of existing barriers to AYA cancer-related pain management in the oncology setting. Oncology providers are providing primary pain management for their patients, but should consider referral to pain specialists when available. Better characterization of cancer-related pain can ideally be leveraged to identify those patients at highest risk for chronic pain and its consequences in survivorship, opening the possibility of developing tailored prevention and intervention strategies.

  PublisherDOI

• Heavy drinking antecedents among bisexual+ and heterosexual women with sexual assault histories: A qualitative inquiry

  Alcohol Clinical and Experimental Research · 2026-02-01

  article

  INTRODUCTION: Bisexual+ women are at high risk for alcohol use and sexual assault; yet reasons for high alcohol use among bisexual+ women remain unclear. The study aimed to examine: (1) antecedents of heavy drinking (i.e., microaggressions, coping motives, psychological distress) that could vary across drinking events and (2) how experiences might differ between bisexual+ and heterosexual women. METHODS: Participants were 45 young adult bisexual+ (n = 24) and heterosexual (n = 21) women who reported heavy episodic drinking (4+ drinks in a sitting) at least four times in the last 30 days and a sexual assault history. Sixty-minute semi-structured individual interviews were conducted. Data were coded and analyzed using thematic analyses. RESULTS: Eight themes were identified. Bisexual+ women were more likely to drink when distressed, and to drink more heavily and at a more accelerated pace relative to heterosexual women. Most participants (bisexual+ and heterosexual women) reported that although experiencing microaggressions did not have a great impact on their drinking, microaggressions did negatively impact their mood for the rest of their day. Drinking was greater when women experienced psychological distress; this connection was more salient among bisexual+ women. Both positive (i.e., social and enhancement) and negative reinforcement (i.e., coping) drinking motives were salient among both bisexual+ and heterosexual women. CONCLUSIONS: Bisexual+ women have unique experiences related to heavy drinking antecedents that are distinct from those experienced by heterosexual women. Findings highlight the importance of understanding risk factors for heavy drinking among bisexual+ women with histories of sexual assault.

  PublisherDOI

• Perspectives from Systems-Level Key Informants on Optimizing Opioid Use Disorder Treatment for Adolescents and Young Adults

  Children · 2025-07-02 · 1 citations

  articleOpen accessSenior authorCorresponding

  Background/Objectives: Rates of receiving opioid use disorder (OUD) treatment among adolescents and young adults (AYA) aged 16–25 are low. The current study qualitatively analyzed informants’ perspectives regarding the availability of, developmental considerations relevant to, and barriers associated with OUD treatment for AYA. Methods: Thirty key informants involved with OUD treatment in the northeastern United States completed individual, semi-structured interviews, including treatment providers (N = 11) and clinic leaders in programs that provide medication and psychosocial treatments for AYA with OUD (N = 10), as well as opioid-related policymakers (N = 6) and patient advocates (N = 3). Interviews were transcribed and independently double coded. Template-style thematic analysis methods were used and revealed seven themes. Results: The first theme highlighted limited treatment program availability for adolescents (aged < 18 years) with OUD. Four themes related to developmentally optimizing OUD treatment for AYA, describing the importance of caregiver involvement, AYA peer connections, wraparound services, and early intervention. Two themes described barriers to AYA OUD treatment, including stigma and knowledge gaps about medications for OUD as well as deficits in AYA’s access to basic resources (e.g., housing, food security) that prohibit effective participation in treatment. Conclusions: Results highlight concerns from systems-level key informants regarding gaps in OUD treatment options for youth under the age of 18 and a high need for OUD treatment that is developmentally tailored to AYA. Findings point toward potential modifications and additions to existing adult treatment programs to make OUD treatment more accessible, relevant, and engaging for AYA.

  PublisherOA PDFDOI

• Optimizing psychological treatments for pediatric chronic pain to enhance outcomes, availability, and accessibility

  Current Opinion in Psychology · 2025-03-13 · 3 citations

  reviewOpen access1st authorCorresponding

  Although the evidence-base for psychological treatments for pediatric chronic pain (CP) is promising, the rigor and quality of existing studies remains variable and psychological treatments for pediatric CP are often inaccessible to youth that may benefit. Persistence in the rates and devastating impact of chronic pain for children and adolescents suggests a need to improve both the quality and availability of psychological treatments for pediatric CP. This brief review aims to provide an overview of the primary developmentally tailored, evidence-based, psychological treatments for pediatric CP (e.g. Cognitive Behavioral Therapy and Acceptance and Commitment Therapy). We also highlight two requisite directions for future research and program development efforts on psychological treatments for pediatric CP: 1) optimizing and tailoring treatments for real world treatment settings in partnership with end users (i.e. youth, providers) and 2) addressing barriers at multiple levels which impact both the availability and accessibility of evidence-based psychological treatments for CP.

  PublisherDOI

• Mental Health Consequences of Opioid Pain Medication Use Behaviors and Motives Among Adolescents and Young Adults With Cancer: Results From a National Survey

  Psycho-Oncology · 2025-01-01 · 2 citations

  articleOpen access

  BACKGROUND: Adolescents and young adults (AYA) with cancer experience long-term consequences into survivorship that impact quality of life, including mental health symptoms, substance use, and persistent pain. Given the elevated rates of pain, AYA cancer survivors are at increased risk for opioid pain medication (OPM) exposure, increasing risk for opioid-related negative consequences, particularly for those with mental health symptoms. Minimal research has documented that a considerable proportion of AYAs with cancer receive OPM that continues into survivorship, yet the lack of consensus on the definition of problematic opioid use coupled with the high clinical need for OPM makes it particularly challenging to understand the impact of OPM use in this population. AIMS: Therefore, the current study examined differences in opioid pain medication use, use behaviors, and motives between AYA cancer survivors and non-cancer controls. METHODS: Using the National Survey on Drug Use and Health, we tested the impact of OPM use behaviors and motives on depressive symptoms and mental healthcare utilization variables. RESULTS: Results show that, compared to non-cancer controls, AYA cancer survivors evince higher rates of opioid use, behaviors, and pain relief motives. Within the cancer survivor group only, there were differential patterns of associations between OPM behaviors, motives, depressive symptoms, and mental healthcare utilization, with using opioid pain medication for emotion coping/to get high showed the largest effect sizes with outcome variables. CONCLUSIONS: The results highlight the importance of moving beyond use itself and examining how and why AYAs with cancer are using opioids to understand potential negative consequences.

  PublisherOA PDFDOI

• The Multidimensional Assessment of Parenting Scale: Youth Report Form in Inpatient and Partial Hospital Settings

  Journal of Child and Family Studies · 2025-08-01

  articleOpen access

  Abstract The Multidimensional Assessment of Parenting Scale (MAPS) was developed to assess a wide range of behaviors across positive and negative domains of parenting. This study aims to expand the utility of the MAPS by evaluating a youth-report version which provides an additional perspective on parenting practices. The study evaluated the youth-report form of the MAPS (MAPS-Y) in a large clinical population ( N = 628) ranging from middle childhood (8–12) to adolescence (13–17) who were admitted to partial and inpatient psychiatric units. Youth and their caregivers completed the parent and youth versions of the MAPS questionnaire, and measures of child and adolescent psychopathology, emotion regulation, family context, and adversity. Analyses of factor structure, reliability, agreement, and validity were performed. The study also examined a short form of the MAPS-Y for reliability and validity. CFA and model fit indices indicated that all items loaded as expected onto subscales and with good fit. Analyses support strong reliability. The factor structure of the youth-report form was invariant across developmental stages, included both positive and negative domains, and demonstrated strong psychometric properties. The MAPS-Y short form demonstrated strong validity and reliability. The youth-report form of the MAPS and its short form are appropriate for use among children and adolescents experiencing acute clinical symptoms. The MAPS youth-report form will allow for nuanced, in-depth assessment of the parenting behaviors beyond parent-report that are critical to treatment outcomes in youth.

  PublisherOA PDFDOI

• Exploring academic achievement and relevant risk factors among a community sample of adolescents with chronic pain compared to peers

  Journal of Pediatric Psychology · 2025-04-12 · 1 citations

  articleOpen access

  OBJECTIVE: To compare adolescents in the United Kingdom with chronic pain with their peers in relation to psychological and behavioral outcomes (i.e., mental health, bullying, substance use) and academic achievement. METHODS: Participants were adolescents with chronic pain (n = 856) and peers without chronic pain (n = 3,093) from the Avon Longitudinal Study of Parents and Children (ALSPAC) who attended a research clinic in the United Kingdom at 17 years and completed data collection at multiple timepoints. Chi-square and t-tests were used to explore group differences across psychological and behavioral measures. Regression and mediation analyses examined the relationship between chronic pain and academic achievement measures, including the derived variables of pathway to higher education and educational qualifications. RESULTS: Adolescents with chronic pain were found to experience more difficulties with mental health, bullying, and substance use. Additionally, a relationship between chronic pain and reporting a pathway to higher education was found after key variables were accounted for, although group differences were not observed across other academic achievement measures. Further analyses identified a moderate indirect effect of chronic pain on reporting a pathway to higher education when mediated by sleep difficulties. CONCLUSIONS: The limited predictive relationship between chronic pain and academic achievement potentially indicates that, despite struggling more with factors such as mental health, bullying, and substance use, adolescents with chronic pain may utilize enhanced skills in maintaining a developmental trajectory at school or external factors such as support from their caregivers or school. The complex interrelationship between sleep and chronic pain is also an important consideration for the ability to achieve academically.

  PublisherOA PDFDOI

• #Opioids: A Mixed-Methods Examination of Top Opioid-Related Content on TikTok

  Journal of Studies on Alcohol and Drugs · 2024-12-27

  articleOpen accessSenior author

  OBJECTIVE: Despite an abundance of public discourse about the opioid crisis in the media, there is little research characterizing opioid-related content on TikTok, a popular video-based social media platform. This study sought to examine how opioids are portrayed on TikTok. METHOD: This study used mixed methods to analyze top opioid-related posts marked with the hashtag "#opioids" collected in May 2023. "Holistic coding" was used to topically categorize multimedia content in posts and to quantify the frequency of mentioning opioid-related content areas (e.g., overdose, pain, fentanyl). Template analysis methods were then used to develop themes. RESULTS: A total of 115 posts were analyzed. The most frequently used opioid-related topic codes include prescription opioids (58.3% of posts), pain (47.0%), overdose (35.7%), and fentanyl (34.8%). Posts were most commonly about challenges to accessing prescription opioids for pain management (37.4%), opioid policy (36.5%), and negative consequences of using opioids (32.2%). Qualitative analysis yielded themes about the potential dangers associated with using opioids, treatment and recovery from opioid use disorder, and barriers to obtaining prescription opioids for pain management. CONCLUSIONS: This study revealed polarizing opinions within opioid-related content on TikTok. The two main stances, dangers of nonmedical opioid use and advocacy for the availability of prescription opioids for pain management, represent nationwide tensions between the opioid and chronic pain crises. The vast audience TikTok garners presents an opportunity for disseminating opioid education, harm-reduction strategies, and treatment options for opioid use disorder that were largely absent among the posts analyzed.

  PublisherOA PDFDOI

• The Multidimensional Assessment of Parenting Scale: Youth Report Form in a Clinical Sample

  medRxiv · 2024-10-03 · 1 citations

  preprintOpen access

  Abstract Objective The Multidimensional Assessment of Parenting Scale (MAPS) was developed to assess a wide range of behaviors across positive and negative domains of parenting. This study aims to expand the utility of the MAPS by evaluating a youth-report version which provides an additional perspective on parenting practices. Method The study evaluated the youth-report form of the MAPS (MAPS-Y) in a large clinical population ( N = 628) ranging from middle childhood (8-12) to adolescence (13-17) who were admitted to partial and inpatient psychiatric units. Youth and their caregivers completed the parent and youth versions of the MAPS questionnaire, and measures of child and adolescent psychopathology, emotion regulation, family context, and adversity. Analyses of factor structure, reliability, agreement, and validity were performed. The study also examined a short form of the MAPS-Y for reliability and validity. Results CFA and model fit indices indicated that all items loaded as expected onto subscales and with good fit. Analyses support strong reliability. The factor structure of the youth-report was invariant across developmental stages, included both positive and negative domains, and demonstrated strong psychometric properties. The MAPS-Y short form demonstrated strong validity and reliability. Conclusion The youth-report of the MAPS and its short form are appropriate for use among children and adolescents experiencing acute clinical symptoms. The MAPS youth-report will allow for nuanced, in-depth assessment of the parenting behaviors beyond parent-report that are critical to treatment outcomes in youth.

  PublisherOA PDFDOI

• Provider perceptions of systems-level barriers and facilitators to utilizing family-based treatment approaches in adolescent and young adult opioid use disorder treatment

  Addiction Science & Clinical Practice · 2024-03-21 · 7 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Amidst increasing opioid-related fatalities in adolescents and young adults (AYA), there is an urgent need to enhance the quality and availability of developmentally appropriate, evidence-based treatments for opioid use disorder (OUD) and improve youth engagement in treatment. Involving families in treatment planning and therapy augments medication-based OUD treatment for AYA by increasing treatment engagement and retention. Yet, uptake of family-involved treatment for OUD remains low. This study examined systems-level barriers and facilitators to integrating families in AYA OUD treatment in Rhode Island. METHODS: An online survey was administered to clinic leaders and direct care providers who work with AYA in programs that provide medication and psychosocial treatments for OUD. The survey assessed attitudes towards and experiences with family-based treatment, barriers and facilitators to family-based treatment utilization, as well as other available treatment services for AYA and family members. Findings were summarized using descriptive statistics. RESULTS: A total of 104 respondents from 14 distinct treatment programs completed the survey. Most identified as White (72.5%), female (72.7%), and between 25 and 44 years of age (59.4%). Over half (54.1%) of respondents reported no experience with family based treatment and limited current opportunities to involve families. Barriers perceived as most impactful to adopting family-based treatment were related to limited available resources (i.e. for staff training, program expansion) and lack of prioritization of family-based treatment in staff productivity requirements. Barriers perceived as least impactful were respondent beliefs and attitudes about family-based treatment (e.g., perception of the evidence strength and quality of family-based treatment, interest in implementing family-based treatment) as well as leadership support of family-based treatment approaches. Respondents identified several other gaps in availability of comprehensive treatment services, especially for adolescents (e.g. services that increase social recovery capital). CONCLUSIONS: Family-based treatment opportunities for AYA with OUD in Rhode Island are limited. Affordable and accessible training programs are needed to increase provider familiarity and competency with family-based treatment. Implementation of programming to increase family involvement in treatment (i.e. psychoeducational and skills-based groups for family members) rather than adopting a family-based treatment model may be a more feasible step to better meet the needs of AYA with OUD. TRIAL REGISTRATION: not applicable.

  PublisherOA PDFDOI

Recent grants

• Barriers and Facilitators to Implementation of Family-Based Treatment for Opioid Use Disorder in Adolescents and Young Adults

  NIH · $134k · 2019–2021

Frequent coauthors

• Laura E. Simons

  28 shared

• Robert Miranda

  Brown University

  27 shared

• Kevin E. Vowles

  Belfast Health and Social Care Trust

  25 shared

• Samuel N. Meisel

  23 shared

• Lino Becerra

  Invicro (United States)

  16 shared

• David Borsook

  Massachusetts General Hospital

  16 shared

• Christine B. Sieberg

  15 shared

• Hayley Treloar Padovano

  Brown University

  15 shared

Labs

• Pielech LabPI

Education

• Ph.D., Clinical Psychology

  University of New Mexico

• M.S., Clinical Mental Health Counseling and Expressive Arts Therapy

  Lesley University

Awards & honors

• F32 fellowship from the National Institutes on Drug Abuse (N…