The PMHNP has diagnosed an 8-year-old boy with oppositional defiant disorder (ODD). Which of the following is the most effective treatment?

Choice A reason: Family therapy focused on child management skills is evidence-based for ODD. It trains parents to use consistent discipline, positive reinforcement, and behavioral strategies to manage oppositional behaviors effectively, directly targeting the core problems of the disorder. Choice B reason: Structural family therapy emphasizes family hierarchy and multigenerational patterns but is less directly focused on behavioral management of ODD in children. Choice C reason: Cognitive behavioral therapy can help the child recognize thoughts and behaviors but is less effective if parents are not simultaneously trained in behavior management techniques, which are critical in ODD. Choice D reason: Family systems therapy with integrated behavior modification may be helpful, but the primary evidence supports targeted parent-focused behavioral management as most effective for ODD.