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BIRP note template for therapy sessions

By Albert Wong, PhD, Clinical Psychologist

BIRP — Behavior, Intervention, Response, Plan — is the progress-note format that puts the clinician's work at the center. Where SOAP and DAP organize a note around information (reported, observed, interpreted), BIRP organizes it around a causal chain: how the client presented, what you did about it, how they responded, and what happens next. That chain is precisely what utilization reviewers look for, which is why BIRP became the house format of community mental health, agencies, and much of publicly funded behavioral health.

Choose BIRP when your setting requires it, when your documentation must visibly demonstrate active goal-linked treatment, or when your own notes have a "we talked about..." drift you want the structure to correct. If you would rather lead each note with the treatment-plan goal itself, GIRP is the same chassis with a goal-first opening; the format overview compares all four common formats.

The template

Plain text — paste into any EHR or document
BIRP PROGRESS NOTE

Client name: ____________________   Date of service: ____________
Start / end time: _______________   CPT code: ____________
Clinician: ______________________   Location / modality: ____________

B — BEHAVIOR
The client's presentation and report: what you saw and what they said.
- Appearance, mood, affect, and engagement as observed:
- Client's reported symptoms and concerns today:
- Change since last session (frequency / intensity where possible):
- Measure scores administered today, if any:

I — INTERVENTION
What YOU did this session — specific and named.
- Therapeutic interventions used (e.g., cognitive restructuring,
  exposure planning, skills training, psychoeducation):
- Treatment plan goal(s) these interventions addressed:

R — RESPONSE
How the client responded to those interventions.
- In-session response (engagement, skill uptake, insight, affect
  shift):
- Client's own feedback on the intervention, where given:
- Barriers or resistance observed:

P — PLAN
- Interventions planned for next session:
- Homework or between-session practice assigned:
- Risk assessment (suicidal or homicidal ideation: denied /
  present — if present, document assessment and action taken):
- Referrals or care coordination:
- Next appointment:

Clinician signature / credentials: ____________  Date signed: ________

A filled example

"Jamie A." is a fictional client — every detail below is invented and deliberately generic. Never copy identifying details from real charts into templates or samples.

Fictional example — for structure, not content
BIRP PROGRESS NOTE — FILLED EXAMPLE (fictional client)

Client name: Jamie A. (fictional)   Date of service: 03/12/2026
Start / end time: 11:00 - 11:55     CPT code: 90837
Clinician: S. Lindqvist, LMFT       Location / modality: Office, in person

B — BEHAVIOR
Jamie arrived on time, casually dressed, adequately groomed.
Cooperative and engaged throughout. Mood described as "flat but okay";
affect mildly restricted, brightening in the second half of session.
Reported low motivation on 3 of 7 mornings this week and skipping one
planned walk, but completed the activity log as assigned. PHQ-9
administered: score 9 (mild), unchanged from two weeks ago.

I — INTERVENTION
Reviewed the weekly activity log using behavioral activation
framework (treatment plan goal 1: increase engagement in valued
activities). Guided Jamie through identifying the two highest-mood
activities on the log and scheduling both for the coming week.
Provided psychoeducation on the activity-mood link, using Jamie's own
log data as the illustration.

R — RESPONSE
Jamie engaged actively with the log review and identified the pattern
without prompting ("the mornings I move, the day goes better").
Scheduled both activities into specific days and expressed mild but
genuine willingness ("I can do two"). No resistance observed; asked
one clarifying question about what to do on a low-motivation morning,
and rehearsed the five-minute starter rule in response.

P — PLAN
Continue weekly individual sessions. Homework: complete the two
scheduled activities and keep the daily activity-mood log. Next
session: review log; if mood ratings remain flat for two more weeks,
revisit treatment plan and consider frequency change. Denied suicidal
and homicidal ideation this session; no risk indicators observed.
Next appointment: 03/19/2026, 11:00.

Clinician signature / credentials: S. Lindqvist, LMFT   Date signed: 03/12/2026

The two sections that decide whether the note works

Practice Harbor's note templates include BIRP, with AI drafting that writes the first draft from your session for you to review, edit, and sign — the structure above, without the blank page.

Common questions

What actually counts as an "intervention" in a BIRP note?

Something you did, named specifically enough that another clinician could picture it: guided cognitive restructuring of a specific belief, reviewed an exposure hierarchy, taught paced breathing, conducted behavioral activation scheduling, provided psychoeducation on a named topic. "Provided supportive therapy" and "discussed feelings" are the classic audit findings — they describe presence, not treatment. A good test: could the intervention line be copied into any other client’s note unchanged? If yes, it is too vague.

Who is BIRP for — is it required in community mental health?

BIRP grew up in agency and publicly funded behavioral health, where documentation must show actively delivered, goal-linked treatment, and many agencies standardize on it for that reason. But the mandate, where one exists, almost always comes from the agency or a specific contract — not from the format having legal status. If you work for an agency, use what it requires. In private practice, BIRP is simply a good choice when you want interventions and responses to be impossible to omit.

What is the difference between BIRP and GIRP?

The first letter. BIRP opens with the client’s Behavior (presentation and report); GIRP opens with the treatment plan Goal the session addressed. The remaining three sections are the same. GIRP forces the note to connect to the treatment plan from the first line, which some settings prefer for demonstrating medical necessity; BIRP reads more like a clinical narrative. See our GIRP template for the goal-first version.

Where does risk assessment go in a BIRP note?

BIRP has no dedicated risk section, so pick a consistent home and never skip it. Observed indicators belong in Behavior; a screening you performed is an Intervention with the outcome in Response; our template anchors the routine "denied SI/HI" statement in Plan so it is never dropped. When risk is present, it takes over the note: document the assessment, your clinical reasoning, the safety plan, and every action taken.

Can I use BIRP for group therapy notes?

Yes — it adapts well, with one rule: each group member gets their own note, and the note describes that member. The Intervention section can legitimately describe what you did with the group (the shared curriculum or exercise), but Behavior and Response must be individual: how this member presented, participated, and responded. Identical Response sections across a group’s charts are a well-known audit red flag. Never name other group members in a client’s note.

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This template and guidance are general clinical-documentation education, not legal advice. Documentation requirements vary by state, license type, agency policy, and payer contract — check yours.

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