Background: Adolescent idiopathic scoliosis (AIS) treatment depends heavily on brace compliance, which can be significantly influenced by psychosocial and neurodevelopmental factors. Adolescents with psychiatric comorbidities may face heightened challenges that increase the risk of curve progression and surgical intervention.

Objective: To describe a biopsychosocial, patient-centered orthotic management approach for an adolescent with highmagnitude scoliosis and complex mental health comorbidities.

Methods: A 14-year-old Risser 1 female with progressive double-curve scoliosis was treated using a full-time thoracolumbosacral orthosis based on a Rigo-Chêneau design. Care incorporated motivational interviewing, shared decision-making, cosmetic customization, compliance monitoring, peer support resources, and enhanced follow-up frequency within a coordinated multidisciplinary framework.

Results: Over eight months, the patient demonstrated exceptional engagement and adherence despite significant psychosocial stressors, including psychiatric emergency evaluation and rapid growth.

Conclusion: Integrating humanistic and behavioral health–informed strategies into conservative scoliosis care may substantially improve treatment adherence in complex adolescent cases.