Clinical support

How to write an ODD treatment plan

Develop effective ODD treatment plans with goals, guidance, and a sample treatment plan for ODD — plus ongoing documentation support from Headway.

December 19, 2025

9 min read

Oppositional defiant disorder, or ODD, includes outbursts of anger, irritability, and overall defiance that can make it hard to function in everyday life. The good news is that therapy can be a great source of support for people with ODD — but it’s important to find the right approach for your client.

Crafting an effective ODD treatment plan can be challenging, especially because people with ODD typically struggle with authority figures. As with any other diagnosis, there’s no one-size-fits-all approach that will help every client, which is why it’s so important to customize your treatment plan according to your client’s unique needs and your professional expertise. Below, learn more about how to write an ODD treatment plan for your clients.

Key takeaways

Clients with ODD typically present with anger outbursts, irritability, and overall defiance to adults and authority figures.
ODD treatment plans should consider the unique needs of your client and their symptoms while incorporating evidence-based treatment approaches and other best practices.

DSM-5 diagnostic criteria for ODD

An accurate diagnosis is key for effective treatment planning and billing insurance payers. While it commonly manifests in young children, ODD can affect anyone at any age. Diagnosing oppositional defiant disorder requires certain criteria, which are outlined in the DSM–5-TR:

A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms of the following categories, and exhibited during interaction with at least one individual who is not a sibling:

Angry/irritable mood

Often loses temper
Is often touchy or easily annoyed
Is often angry and resentful

Argumentative/defiant behavior

Often argues with authority figures or, for children and adolescents, with adults
Often actively defies or refuses to comply with requests from authority figures or with rules
Often deliberately annoys others
Often blames others for his or her mistakes or misbehavior

Vindictiveness

Has been spiteful or vindictive at least twice within the past 6 months.

B. The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues) or it impacts negatively on social, educational, occupational, or other important areas of functioning,

C. The behavior does not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also the criteria are not met for disruptive mood dysregulation disorder.

What to include in a treatment plan for ODD

How you treat clients with ODD ultimately depends on their symptom profile and your expertise as a therapist. Treatment planning should always be collaborative and should reflect the client's goals and experience of symptoms. All treatment plans must include a goal, objective, and intervention. You should also incorporate evaluation criteria to help you determine whether a client is improving over time.

Remember: Treatment isn’t one-size-fits-all — but in general, it’s a best practice to include at least one goal and objective from each diagnostic criteria your client experiences and to base interventions on psychological evidence and clinical training.

Depending on the specific case, you may include components that address the following aspects of oppositional defiant disorder.

Reduce the intensity and frequency of hostile behavior

Because ODD involves opposition to adults or authority figures, one of the most important treatment goals is to reduce the overall intensity and frequency of hostile behaviors, such as anger, irritability, arguing, and vindictiveness. Evidence-based treatment modalities such as cognitive behavioral therapy (CBT) can help clients with ODD understand the connection between their thoughts, emotions, and behaviors so they can make meaningful changes in their behavior over time.

Instill emotional regulation techniques

Another hallmark symptom of ODD is outbursts of anger, or temper tantrums. Teaching emotional regulation skills, whether mindfulness, grounding techniques, or other anger management tools can help reduce reactivity and equip clients to self-soothe so they can start responding to adults and authority figures with calmness and respect.

Improve and support social skills

People with ODD often struggle to understand and apply social skills because of their reactiveness. Along with emotional regulation techniques that help clients manage their anger and irritability, therapists can teach clients social skills such as mutual respect, empathy, and cooperation.

Teach conflict resolution

ODD can lead to conflicts with parents, teachers, and other authority figures. For older kids or adults, it can be helpful to teach conflict resolution skills that can help repair relationships after an angry outburst or other forms of hostility.

Practice in-network with confidence

Simplify insurance and save time on your entire workflow — from compliance and billing to credentialing and admin.

Talk to a practice consultant

Sample treatment plan for oppositional defiant disorder

Your treatment plan should be customized to your clients’ unique needs and goals, but following certain themes can help ensure you effectively support clients diagnosed with ODD. Below, find a sample treatment plan as a reference.

Case example

Jordan is a 9-year-old boy who has struggled with persistent anger and defiant behavior over the past year. At home, he frequently argues with his parents about daily routines, such as getting ready for school or turning off video games. When asked to complete chores, Jordan often responds with “You can’t make me,” and refuses to comply. At school, he talks back to teachers, leaves his seat without permission, and becomes easily irritated by classmates. Minor requests like lining up quietly or sharing materials can trigger intense frustration, leading him to slam doors or shout.

Jordan reports feeling like “everyone’s always bossing me around,” and believes adults are unfairly targeting him. He often blames others for conflicts, saying, “It’s not my fault! They started it.” These behaviors have strained his relationships at home and resulted in multiple calls from school, leaving his parents feeling overwhelmed and unsure how to help.

Jordan would benefit from the outlined treatment plan to build emotional regulation skills, improve communication, and strengthen more cooperative interactions with both caregivers and teachers.

Goal 1: Reduce the frequency and intensity of defiant and argumentative behaviors

Objective 1.1: Identify 2-3 common triggers (e.g., transitions, requests, sibling interactions) that reliably precede defiant behavior

Intervention 1.1: Work with Jordan and his parents to keep a simple daily “behavior tracker” noting situations and emotions that occur before defiance

Objective 1.2: Reduce reactiveness when he feels adults make unfair requests by practicing “stop, think, respond” at least 3 times per week

Intervention 1.2: Teach and role-play the “stop, think, respond” strategy in session, using real-life examples from home and school

Goal 2: Improve emotional regulation and frustration tolerance

Objective 2.1: Use one calming strategy (e.g., deep breathing, counting to 10, taking space) during moments of anger at least twice per week

Intervention 2.1: Introduce age-appropriate coping skills, model them in session, and practice through games and structured role-play

Objective 2.2: Label and communicate emotions more accurately in daily situations

Intervention 2.2: Incorporate emotion-identification activities (e.g., “feelings chart,” “stoplight emotions”) and practice linking feelings to behaviors

Goal 3: Strengthen positive parent-child interactions and consistent limit-setting

Objective 3.1: Caregivers will use consistent, predictable consequences for noncompliance and 1–2 positive reinforcement strategies daily

Intervention 3.1: Provide parent management training, including guidance on labeled praise, reward systems, and consistent limit-setting

Objective 3.2: Increase positive interactions between Jordan and caregivers to at least 10 minutes of daily “special time”

Intervention 3.2: Coach parents in implementing structured one-on-one time focused on warmth, connection, and positive attention

Explore more treatment plan resources from Headway

Headway supports its providers with treatment plan templates that make it easy to identify and implement the most effective treatment for your client base. Explore the rest of our treatment plan articles for some of the most common conditions therapists treat:

Headway streamlines your practice so you can focus on your clients

Diagnosing and treating oppositional defiant disorder can be challenging, but effective psychotherapy treatment may drastically improve a client’s life. Whether you’re diagnosing someone for the first time, writing or updating a treatment plan, or submitting insurance claims for therapy sessions, Headway is here to support you along the way, so you can invest more time in what matters most.

Headway’s integrated EHR includes assessment tools, documentation templates, and more to help ensure you provide the best possible care to clients while remaining compliant with complex insurance policies and expectations. Ready to take the next step toward growing your practice without the administrative headache? Connect with a Headway representative to learn more about how Headway can help.

Headway helps you help others

Join a network of thousands of mental health providers who have already chosen Headway to streamline their practice and expand their network — at no cost to you.

Talk to a practice consultant

This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

Clinical support

How to write a treatment plan for grief

Grief and mourning are highly personal processes that can look different depending on the individual.

9 therapy prompts for quiet clients

Struggling to engage quiet clients in sessions? Here are some ideas to help spark conversation and build trust in therapy.

Why I stopped using no-harm contracts in my practice

Many therapists were trained to view them as important clinical tools, but they’re not evidence-based.