BIRP Notes: Format & Template
A BIRP note is a progress note with four labeled sections: Behavior, Intervention, Response, and Plan. It records what the client did and said, the intervention you delivered, how the client responded, and what happens next. Community mental health and other publicly funded programs use BIRP because every note documents a service delivered and its effect.
Skip ahead to the blank BIRP note template if that’s all you need. It’s free, no email required, in PDF and DOCX.
What Does BIRP Stand For?
BIRP stands for Behavior, Intervention, Response, Plan. Each letter is a labeled section. Behavior holds the client’s report and your observations together, Intervention holds what you did, Response holds the client’s reaction, and Plan holds the next steps. A BIRP note reads like a service receipt: what prompted the service, what was delivered, what it did, and what comes next.
The format grew up in community mental health rather than in medicine. SOAP descends from a founding paper, Dr. Lawrence Weed’s problem-oriented medical record (Weed, 1968); BIRP has no equivalent single source. It spread through community mental health agencies and publicly funded behavioral health systems because its structure matches what those programs audit for: evidence that a planned, billable intervention actually happened, and evidence of what it produced.
Section | What it captures | Example line |
|---|---|---|
B: Behavior | What the client reported and what you observed, labeled by source. | “Client reports panic attacks ‘most mornings.’ Speech rapid; hands trembling when describing commute.” |
I: Intervention | What you did this contact, tied to a treatment plan goal. | “Taught diaphragmatic breathing; rehearsed a graded exposure plan for the bus route (goal 2).” |
R: Response | How the client reacted, in their words and your observations. | “Client completed three breathing cycles, rated anxiety 7 down to 4, and agreed to attempt one stop this week.” |
P: Plan | Next steps with owners and timeframes. | “Client to practice breathing daily and log attempts; review exposure log next session, one week.” |
B: Behavior
The client’s presentation at this contact: what they told you and what you saw. Concerns in their words, mood report, homework report, plus appearance, affect, speech, attendance, and any measure scores. A mental status exam cheat sheet habit fills the observational half in about a minute, and precise affect descriptors beat “seemed upset” every time. Coming from SOAP, this section works differently than you expect. More on that below.
I: Intervention
What you did, named specifically: the technique, the skill taught, the referral made, the coordination call placed. Use active verbs (taught, modeled, rehearsed, reviewed, coordinated, referred) and tie the intervention to a treatment plan goal. Auditors trace what agencies call the golden thread: the assessment justifies the plan, the plan sets goals, and each note’s Intervention points back to one of those goals. “Provided support” breaks the thread.
R: Response
The client’s reaction to what you did: a quote, a changed rating, a behavioral shift, an agreement or a refusal. A refusal is a response too, and documenting it protects everyone. The section belongs to the client. “Session went well” is your opinion; “client said the breathing exercise ‘actually slowed things down’ and asked to try it at home” is a response.
P: Plan
The concrete next steps: homework, referrals, follow-up actions, safety planning if indicated, and the date and focus of the next contact. “Continue services” is not a plan. Name the step, its owner, and the timeframe.
Behavior Holds Both S and O: The SOAP Habit to Unlearn
Clinicians trained on SOAP notes reach BIRP and immediately look for somewhere to put the split between Subjective and Objective. There isn’t one. BIRP’s Behavior section holds the client’s report and your observations side by side, and the discipline shifts from sorting to labeling. Attribute every line to its source: “client reports” for their account, plain observational language for yours. A reader should never have to guess whether a fact came from the client’s mouth or your eyes.
Line from a contact | Where it goes | Why |
|---|---|---|
“I stopped taking the bus because of the panic.” | Behavior | Client report, labeled as reported. |
Client arrived 20 minutes late, third time this month | Behavior | Your direct observation. |
Taught diaphragmatic breathing | Intervention | Something you did. |
“That breathing thing actually helped.” | Response | The client’s reaction to the intervention. |
“Escalating avoidance consistent with agoraphobia” | Treatment plan or conceptualization | Formulation. BIRP has no section for it. |
The two habits that weaken Behavior sections: dropping the client’s report because “behavior” sounds observational only, and smuggling in interpretation (“client was resistant”). Report and observation both belong here. Conclusions do not.
Where Does the Assessment Go?
BIRP has no assessment section, and that’s a design choice, not an oversight. The note documents service delivery; the clinical formulation lives in the treatment plan and your case conceptualization, which you update at intake, at scheduled treatment plan reviews, and whenever the picture changes materially. The progress note then shows each intervention advancing a goal that the formulation already justifies.
In practice, three options cover most settings. First, keep formulation entirely in the treatment plan and let BIRP notes stay lean; this is the cleanest fit for agency and case management work. Second, if your agency’s documentation policy allows it, close the Response section with a single clinical-impression sentence, phrased tentatively. Third, if you find yourself needing a real assessment in every note, stop fighting the format: a DAP notes template or SOAP gives interpretation its own home.
How to Write BIRP Notes (Step by Step)
Write the sections in order and keep each one a few sentences. The format does the organizing for you.
Open with the treatment plan goal this contact addressed. One line at the top keeps the golden thread visible before you write anything else.
Record the presentation (B). What the client reported and what you observed, each labeled by source. Include attendance and any scores.
Name the intervention (I). The specific technique, skill, referral, or coordination you delivered, with an active verb, tied to the goal from step 1.
Capture the reaction (R). Quote the client, record the changed rating, describe the behavioral shift. If the client declined or showed no discernible change, say so plainly.
Commit to next steps (P). Homework, referrals, follow-up, and the next contact’s date and focus, each with an owner and a timeframe. Then reread as a stranger: could another clinician continue care from this note alone?
A first appointment usually calls for an intake note rather than a BIRP note; start from an intake form template and switch to BIRP once treatment goals exist for the Intervention section to point at. For the wider documentation habit this sits inside (timing, frequency, retention), see how to write therapy progress notes.
BIRP Note Examples
The two examples below cover the settings that use BIRP most: individual therapy and case management. Both describe fictional, composite clients. No real person, session, or record appears here. Both are set in the US; swap the credentials for your own state or province, the structure is identical everywhere.
BIRP Note Example: Individual Therapy
Setting: outpatient clinic, session #7, 50 minutes, Licensed Professional Counselor, CBT for depression. Treatment plan goal 1: reduce depressive symptoms as measured by PHQ-9.
Behavior: Client (41) attended on time, casually dressed, adequate grooming. Reports mood “heavier this week” after a job interview rejection; sleep unchanged at roughly 7 hours. Completed 3 of 5 assigned thought records. Speech soft and slightly slowed; affect dysthymic, congruent with content. Denies thoughts of self-harm. Intervention: Reviewed completed thought records and reinforced the evidence-testing steps client used independently. Conducted in-session cognitive restructuring on the belief “I’ll never get hired,” using evidence for and against (goal 1). Introduced behavioral activation scheduling and built a two-activity plan for the coming week with client. Response: Client rated belief in “I’ll never get hired” at 90% before restructuring and 60% after, generating the alternative “one rejection isn’t a verdict” without prompting. Chose walking and calling his sister as scheduled activities and wrote both into his phone during session. Affect brightened modestly in the final third of session. Plan: Client to complete daily thought records targeting job-search cognitions and log both scheduled activities. Re-administer PHQ-9 at next session. Next appointment in one week, same time.
BIRP Note Example: Case Management
Setting: community mental health center, targeted case management contact, 45 minutes, mental health case manager. Treatment plan goal 3: maintain medication adherence and housing stability post-discharge.
Behavior: Client (58) attended scheduled contact, arriving 10 minutes early by bus. Reports taking medication “most days” but states he missed his refill last week and has “two or three pills left.” Brought a utility shutoff notice dated this month, as staff requested by phone. Grooming marginal; speech organized and goal-directed; affect flat but engaged. Denies thoughts of self-harm. Intervention: Reviewed the shutoff notice with client and completed the utility assistance application together (goal 3). Called the pharmacy with client present to arrange the missed refill and set up blister packaging. Rehearsed a short script for client to report missed doses to his prescriber, and coordinated with the housing support worker by phone regarding the arrears timeline. Response: Client completed the income sections of the application independently and stated “that’s one thing off my mind.” Agreed to blister packs and confirmed he can pick up the refill Friday. Practiced the prescriber script twice, reading from a card the second time without prompting. Declined transportation assistance, preferring the bus. Plan: Case manager to submit the utility application today and confirm receipt within three business days. Client to pick up refill by Friday; case manager to confirm by phone Monday. Housing worker to follow up on arrears plan this week. Next contact scheduled in one week; review medication adherence and application status then.
Blank BIRP Note Template (Copy or Download)
The template below is free to copy, print, or adapt. No email address required. Download the fillable PDF and Editable DOCX.
BIRP PROGRESS NOTE
Client: ______________________ Date: ____________ Time: ____________
Clinician: ____________________ Session/Contact #: ______ Duration: ______
Service type / setting: ____________________________________________
Treatment plan goal addressed: _____________________________________
B: BEHAVIOR
What the client reported and what you observed: concerns in their
words, appearance, affect, speech, attendance, measure scores.
Label the source. Keep interpretation out.
Reported: _________________________________________________________
Observed: _________________________________________________________
Measures / scores (if any): _______________________________________
I: INTERVENTION
What you did this contact: the technique, skill, referral, or
coordination delivered, with active verbs, tied to the goal above.
___________________________________________________________________
___________________________________________________________________
R: RESPONSE
How the client responded: their words, changed ratings, observed
behavior, agreement or refusal. The response belongs to the client.
___________________________________________________________________
___________________________________________________________________
P: PLAN
Next steps with owners and timeframes: homework, referrals,
follow-up actions, and the date/focus of the next contact.
___________________________________________________________________
___________________________________________________________________
Signature / credentials: ________________ Date signed: ____________
If you would rather not fill this in by hand between sessions, Klarify drafts the whole note from your session. More on that after the mistakes list.
BIRP vs SOAP vs DAP: Which Format Fits?
The formats differ in two places: how they handle the front of the note, and whether interpretation gets its own section. BIRP leads with behavior and skips the assessment entirely. SOAP splits report from observation and interprets in the middle. DAP merges the front and keeps the interpretation.
Format | Sections | The distinguishing move | Reach for it when |
|---|---|---|---|
BIRP | Behavior, Intervention, Response, Plan | Leads with behavior, gives the intervention its own section, no assessment | Community mental health, publicly funded programs, service-delivery audits |
Subjective, Objective, Assessment, Plan | Separates report from observation | Insurers, agencies, or interdisciplinary teams expect the split | |
Data, Assessment, Plan | Merges report and observation, keeps an Assessment | Solo talk-therapy practice where formulation belongs in every note | |
Data, Assessment, Response, Plan | Keeps the Assessment and adds a Response section | Intervention outcomes and interpretation both need to stand out | |
GIRP / PIRP | Goal or Problem, Intervention, Response, Plan | Swaps BIRP’s opener for the goal or the problem | Agencies whose documentation is organized around plan goals or problem lists |
If your program bills Medicaid or reports to a state behavioral health authority, BIRP or one of its siblings is probably already the house format. If nobody requires an intervention-led note and you miss having an assessment section, DAP is the closest exit.
Common BIRP Note Mistakes
Most weak BIRP notes fail in the same six ways, and four of them are section-discipline problems. Scan your note against the left column before you sign it.
Mistake | What it looks like | Fix |
|---|---|---|
Intervention buried in Behavior | “Discussed coping skills with client” filed under B | B holds the presentation. Anything you did goes in I. |
Vague intervention verbs | “Provided support.” “Discussed feelings.” | Name the technique and the goal it serves. Taught, modeled, rehearsed, referred. |
Response written as your opinion | “Client did well today.” | Record the client’s words, ratings, or behavior. A refusal counts too. |
Diagnosis smuggled into Behavior | “Client was manic and paranoid.” | Describe observable behavior; formulation lives in the treatment plan. |
A vague Plan | “Continue services.” | Name the next step, its owner, and when it happens. |
Copy-forward drift | Last week’s note pasted in with a new date | Each note must reflect that contact. Auditors compare consecutive notes for repeated text. |
What Do Regulators Require?
No US board or Canadian college mandates the BIRP format. Agencies and payers choose it; regulators govern what a record contains and how long you keep it. A complete BIRP note meets content expectations comfortably because the intervention and its outcome are explicit. Retention is where the rules actually live.
United States
HIPAA sets no retention period for clinical records; retention comes from state law and your licensing board (HHS, HIPAA FAQ 580). The APA’s Record Keeping Guidelines suggest keeping full records for seven years after the last service for adults, or three years after a minor reaches majority, whichever is later, absent a stricter state rule (APA, 2007). Medicaid-funded programs often add their own documentation and retention requirements through state provider agreements, so check your agency’s contract alongside your board’s rules.
Canada
Canadian searchers often type “counselling notes” with two Ls; the spelling changes, the format doesn’t. What changes is the governing law and the retention clock. Health-information rules come from PHIPA in Ontario and PIPEDA federally, and record-keeping standards come from your college. CRPO requires Registered Psychotherapists to keep clinical records for at least ten years from the last interaction, or ten years after a minor client turns 18 (CRPO Professional Practice Standards, Section 5). Ontario social workers document under OCSWSSW’s Principle IV: The Social Work and Social Service Work Record. Outside Ontario, OPQ, OTSTCFQ, BCACC, and the other provincial bodies each publish their own standard, and the college’s document beats any template page, including this one.
Klarify Writes BIRP Notes for You
Klarify, an AI assistant for therapists in the United States and Canada, drafts BIRP notes from the session itself: in-person session audio, virtual meeting audio, session dictation, handwritten notes, an uploaded transcript, or an uploaded audio file. BIRP is one of its 20+ built-in formats, alongside SOAP, DAP, GIRP, and others, and if your agency uses a BIRP variant with extra fields, custom templates are included on every plan: paste the blank template above in once and Klarify follows it from then on. Audio upload depends on your plan, so check the current details on klarify.ca. Klarify is fully HIPAA, PHIPA, PIPEDA, Quebec Loi 25, and GDPR compliant, offers BAAs on request, stores all data in Canada, and deletes session audio from storage within 14 days, or earlier if you set it. Every therapist also gets a free Psychology Today-style public profile hosted on klarify.ca, with built-in marketing features to attract clients.
The Response section is the first casualty of a note written from memory at the end of a full caseload day: what the client actually said after the intervention blurs into what you hoped they’d say. A scribe that heard the session can quote it. Klarify also generates session context, visual mindmaps of client themes, and reflection prompts for you after each session, so the note is the floor of what you get back, not the ceiling.
Klarify writes BIRP notes for you, start free
Frequently Asked Questions
What does BIRP stand for in mental health notes?
BIRP stands for Behavior, Intervention, Response, and Plan. Behavior holds what the client reported and what you observed, Intervention holds what you did during the contact, Response holds how the client reacted, and Plan holds the next steps. The format is most common in community mental health and other publicly funded behavioral health programs.
What goes in the Behavior section of a BIRP note?
Both the client’s report and your direct observations: presenting concerns in the client’s words, appearance, affect, speech, attendance, and any measure scores. BIRP does not split subjective from objective the way SOAP does. Everything lands in Behavior, labeled by source: “client reports” for their account, plain observational language for yours.
Does a BIRP note have an assessment section?
No. BIRP moves from facts (Behavior) straight to what you did (Intervention) and what happened (Response). Your clinical formulation lives in the treatment plan and case conceptualization, which you update at scheduled reviews. If your agency allows it, a one-line clinical impression can close the Response section. If you need a full assessment in every note, DAP or SOAP is the better format.
What is the difference between BIRP, GIRP, and PIRP notes?
All three share the same last three sections: Intervention, Response, and Plan. They differ only in the opener. BIRP leads with the client’s behavior at the contact, GIRP leads with the treatment goal the session addressed, and PIRP leads with the problem being treated. Agencies pick the opener that matches how their treatment plans are organized.
What is the difference between BIRP and SOAP notes?
SOAP splits the client’s report (Subjective) from your observations (Objective) and includes an Assessment section for clinical interpretation. BIRP merges report and observation into one Behavior section, gives the intervention its own section, and has no assessment section at all. Choose SOAP for medical and interdisciplinary settings; choose BIRP when each note must show a service delivered and its effect.
How long do I need to keep BIRP notes?
The format does not change the retention rule. In the US, HIPAA sets no retention period for clinical records; state law and your licensing board do, and the APA recommends keeping full records for seven years after the last service for adults. In Ontario, CRPO requires at least ten years from the last interaction. Check your own board or college before you commit to a schedule.