Background. Among the most common diseases of the musculoskeletal system are pathologies of the spine, in particular scoliosis and vertebral compression fractures, most commonly found in adolescents. The psyche of such patients is negatively affected by the concomitant motor limitations, pain syndromes, cosmetic defects, long hospitalizations, the threat of surgical treatment, and disability. At the same time, there are practically no complex psychological studies of adolescents with spinal pathologies, which prevents the development of differentiated directions of psychological assistance necessary for their full rehabilitation. Aim. This study aimed to determine the specificity and direction of psychological assistance for adolescents with spinal pathologies of various genesis on the basis of complex psychological research. Materials and methods. The study sample consisted of 38 adolescents (15 boys and 23 girls) with dysplastic scoliosis of various severity (18 with mild severity (grade I–II) and 20 with high severity (grade III–IV)), 29 adolescents (14 boys and 15 girls) with vertebral compression fractures, and 34 adolescents (15–17 years old) without pathology of the musculoskeletal system (control group). As a method, psychological testing was used, aimed at studying the personal traits, world view, and lifestyle of adolescents. Results. In the adolescents with scoliosis, negative reflections of various life spheres in the world view were demonstrated through a decrease in overall activity, internal restraint, disregard for one’s needs, and a reduction in the time spent on learning activities. On the other hand, adolescents with vertebral compression fractures demonstrated negative ideas about the prospects for self-realization, a decreased interest in intellectual activity, along with increased time spent on passive leisure, and a tendency to risky behavior. The revealed features differ depending on the degree of severity, sex, and relation to medical rehabilitation. Differentiated directions of psychological assistance are defined on the basis of the results obtained. Conclusion. A differentiated approach to psychological assistance requires considering the nature of the disease (congenital or acquired), severity and duration, frequency of hospitalizations, relationship to restorative treatment, and sex.