Learn how to create a treatment plan for clients with impulse-control disorders. Find strategies for behavior management, medication, and long term support.
September 18, 2025 • Updated on September 11, 2026
By the Headway Editorial Team
6 min read
By the Headway Editorial Team
Recovery from various disruptive, impulse-control, and conduct disorders (DICCDs) isn't about willpower alone — it depends on a structured plan. When you and your client build a thoughtful roadmap for treatment, change becomes possible and sustainable. Here’s how you can begin writing a treatment plan for DICCDs.
What to know
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Multiple diagnoses fall under the umbrella of disruptive, impulse-control, and conduct disorders. To an outside observer, each condition might look quite different. But, at their hearts, they all involve difficulty controlling impulses.
Each DICCD has its own symptoms, but there are some shared characteristics that show up across conditions. These include:
These behaviors often emerge during childhood, though they can last well into adulthood. Most DICCDs are more common among boys than girls.
Each specific disorder within the DICCD family has its own DSM-5-TR diagnostic criteria and, accordingly, its own ICD-10 code(s). Some conditions within this group have overlapping symptoms, but it’s important to narrow in on the right DSM diagnosis and ICD-10 code. That specificity helps define treatment and avoid administrative complications, such as denied or delayed claims.
| Diagnosis | Core criteria | ICD-10 code(s) |
|---|---|---|
| Oppositional defiant disorder (ODD) | Developmentally inappropriate defiant, hostile, or disobedient behavior directed at authority figures | F91.3 |
| Conduct disorder | Behavior in a child or teenager that violates the rights of others and/or social norms | F91.0, F91.1, F91.2, F91.8, F91.9 |
| Intermittent explosive disorder (IED) | Frequent, impulsive outbursts of anger or aggression that are out of proportion with their contexts | F63.81 |
| Pyromania | Repeated, strong impulses to set fires | F63.1 |
| Kleptomania | Frequent, strong impulses to steal, despite items being neither wanted nor needed | F63.2 |
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The DSM-V-TR section titled “Disruptive, Impulse-Control, and Conduct Disorders” includes the diagnoses of oppositional defiant disorder (ODD), conduct disorder, intermittent explosive disorder, kleptomania, and pyromania. There are a variety of treatment approaches that can be applied for these DICCDs.
CBT is a central treatment for DICCDs. Here, the focus is on identifying and changing distorted thoughts that lead to intense emotions and the impulsive actions that are causing problems. If clients can shift their thoughts towards more rational, grounded thoughts, they can reduce the intensity of their feelings and manage their behaviors more effectively.
This approach to treatment can include CBT as well as dialectical behavior therapy (DBT), mindfulness-based approaches, and relaxation techniques. The intent is to help clients focus on awareness and acceptance of their emotions, developing healthier alternative responses to those emotions, and thus reducing their impulsive reactions.
A comprehensive evaluation is required to diagnose a DICCD, which can be conducted by a psychiatrist, psychologist, or therapist. While an evaluation is not required to be conducted by a psychiatrist, this can help determine if psychotropic medications should be prescribed to address impulsive behavior and emotion dysregulation. These medications can include selective serotonin reuptake inhibitors (SSRIs). Less frequently used are mood stabilizers, antiepileptic medications, and sometimes antipsychotics. No medications are FDA-approved specifically for DICCDs, but off-label use is common to address symptoms such as impulsivity or mood dysregulation.
One of the biggest benefits of support groups for DICCDs is helping clients build self-efficacy, or the belief that they can create and sustain changes. Structured groups can also support goal-setting, skill building, and mutual accountability. This promotes encouragement, impulse management, and emotion regulation.
Psychoeducation can help clients gain insight into their triggers and urges. This may help them identify the escalation of their impulses and have a better chance of responding in a more effective way. Psychoeducation for family members can help them recognize triggers as well, and provide support through a positive environment that reinforces more positive behaviors.
A healthy, balanced lifestyle can make a major impact on trigger reduction and enhanced self-regulation. Adequate sleep, healthy meals, exercise, and stress reduction activities like meditation can all be part of this holistic approach. Setting achievable goals and avoiding triggering environments should also be included with this portion of the treatment plan.
A personalized crisis plan is necessary, especially for clients whose impulsive behaviors can cause harm to themselves or others. This plan can be developed collaboratively among the client, therapist, and family members. It should list triggers, de-escalation coping skills, monitoring plans, supportive medications if applicable, as well as crisis line phone numbers if situations escalate. The goal of these plans is to bring awareness, provide alternatives to the client, reduce harm, intervene early before damage is done, and maintain safety for everyone.
Involving family in the treatment plan can impact outcomes of any DICCD. This is particularly true with ODD and conduct disorder because they are diagnosed only in children and adolescents. When families receive psychoeducation and participate in therapy, they can provide the client with greater emotional support, accountability, and barriers to impulsive behavior. It's also helpful to teach family members communication and de-escalation skills to apply in challenging moments.
Treating trauma can be an essential component for clients with a DICCD. The trauma may be underlying their emotional dysregulation and impulsive behaviors. A trauma-informed treatment plan can help guide the client and clinician to treatment approaches that help achieve better outcomes. Some possible approaches include EMDR, trauma-focused CBT, somatic experiencing, or CPT. Addressing trauma should always be done in a safe and structured way, ensuring the client is well prepared to do that work.
When creating a treatment plan there are some key things to keep in mind, particularly when planning treatment for DICCDs.
A comprehensive assessment is necessary to properly diagnose and treat a DICCD. One of the first steps is to rule out any medical, substance-use related, or other mental health disorders that could be an explanation for the symptoms. A full clinical interview with the client, and family members if applicable, can provide useful information about emotional and behavioral patterns. Validated assessment tools can also help to gain clarity on symptoms such as the MIDI and BIS-11.
Part of a DICCD treatment plan should include work to help clients identify their impulse triggers and patterns. Therapy can include functional analysis or behavior chain analysis (DBT) to break down each component of a client’s impulsive actions. Clients can also use trackers and journals, such as a CBT thought record, to record their thoughts, emotions, and impulses in specific situations. Once the client has identified some of these patterns, they can then start to work on anticipating, managing, and reducing their impulsive reactions.
Goals in a treatment plan should be SMART, or specific, measurable, achievable, relevant, and time-bound. Working with the client to identify tangible behavioral outcomes is an important component of this. Examples of measurable behavioral outcomes could include reduction of the frequency of impulsive actions in a week or month; the application of specific coping skills or impulse management strategies in specific situations; identifying and verbalizing triggers from the week in each therapy session; or increasing the number of therapeutic tasks each week (e.g., role-playing conflict management). These outcomes can be measured through behavior trackers and direct observation.
A combination of therapy and medication is a best-practice approach for DICCDs. Therapies such as CBT and DBT in tandem with psychiatric care can increase the effectiveness of care. Therapeutic treatments can help with identifying triggers, reducing harmful thought patterns, helping clients learn alternative coping skills and develop strategies to manage their impulses. Psychiatric care such as medication management can help to stabilize mood, reduce the intensity of urges, and manage co-occurring conditions. Coordination of care between therapists, psychiatrists, and other providers can help to offer holistic support across emotional, behavioral, and biological aspects of the client’s lives.
Once the treatment plan is in place, it must be regularly reviewed and monitored for progress. Ongoing monitoring can be managed through client self-report, therapist observations, ongoing assessments, collateral reports through family members, and behavior trackers. Multiple monitoring methods used together can help to give the most accurate picture of progress.
Anxiety, mood disorders, substance use disorders, ADHD, and personality disorders are some of the most common co-occurring mental health challenges for clients with a DICCD. Integrating therapy modalities that can treat these symptoms, such as CBT or DBT, relevant medication management strategies, psychoeducation, and coordination of care with other providers are all important pieces to managing the complexity of these co-occurring disorders.
Client Name: Jane Doe
Therapist Name: Alex Therapist, LCSW
Date of Birth: 6/12/85
Date: 8/24/25
DIAGNOSIS CODE / NAME: F63.2 Kleptomania
MAIN PRESENTING SYMPTOMS:
Repeated, irresistible urges to steal items not needed for personal use or monetary value. Experiences rising tension before theft and relief after, followed by guilt and shame. Stealing episodes have occurred weekly for over a year. Reports anxiety, restlessness, and intrusive urges, especially during times of stress.
MODALITY PLANNED (Indiv., Couples, Family, Group):
FREQUENCY AND DURATION OF SESSIONS PLANNED:
ESTIMATED LENGTH OF TREATMENT:
TREATMENT GOALS and OBJECTIVES
LONG-TERM GOAL #1:
ESTIMATED GOAL COMPLETION DATE:
Objective 1:
Objective 2:
LONG-TERM GOAL #2:
ESTIMATED GOAL COMPLETION DATE:
Objective 1:
Objective 2:
EVIDENCE-BASED INTERVENTIONS
While client willpower plays a role, recovery from various DICCDs is about having a structured, evidence-based treatment plan tailored to each individual’s unique needs. Headway’s platform supports providers by simplifying practice management and facilitating access to resources, empowering clinicians to deliver comprehensive care.
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.
© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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