A good BIRP note example teaches more than a definition. Below you'll find three complete BIRP notes from invented sessions: an individual telehealth session, a session where the plan did not work, and a couples session. The first one is rewritten as a DAP note and a SOAP note so you can see what each format changes. You'll also get a template you can copy, words to reach for in each section, and a 60-second check to run before you sign.
Every client in this article is invented. Any resemblance to a real person is a coincidence.
What a BIRP note is, in one minute
BIRP stands for Behavior, Intervention, Response, Plan. It is a progress note format: a structured record of one session that shows what you observed, what you did, how the client responded, and what happens next. You'll see it in community mental health, substance use treatment and private practice, especially where insurers review notes.
A BIRP note is a progress note, part of the client's record. It is not a "psychotherapy note" in the HIPAA sense. HIPAA defines psychotherapy notes as notes kept separate from the rest of the record, and it excludes from that definition session start and stop times, the modalities used, the treatment plan, symptoms and progress to date (45 CFR 164.501). Those are exactly what a BIRP note contains. That matters because clients can generally ask for a copy of their record, progress notes included (45 CFR 164.524). Write every note as if your client will read it one day.
BIRP fits best when your work centers on specific techniques and you want each note to show whether they helped. Because Intervention and Response are separate sections, the link between what you did and what changed is hard to miss. It is a less natural fit for long, exploratory sessions where your clinical reading matters more than any one technique; DAP or SOAP gives that reading its own section.
What goes in each section
The ACA Code of Ethics asks counselors to "create, safeguard, and maintain documentation necessary for rendering professional services" (ACA Code of Ethics, A.1.b), and the APA Record Keeping Guidelines ask psychologists to keep records that are accurate, current and pertinent. BIRP is one way to meet that standard in a few minutes per session.
Behavior
What the client said and did, and what you observed. Include short quotes, how the client arrived and engaged, speech and affect, scores on any measure you gave (with last time's score), what changed since the last session, and the result of a risk screen when you did one.
Leave out labels without evidence ("manipulative", "resistant", "in denial") and your interpretation. A useful test: could a colleague who wasn't there picture the session from this section alone?
Intervention
What you did, named specifically and tied to the treatment plan. "Used CBT" tells a reviewer almost nothing. "Used Socratic questioning to test the thought 'If I make a mistake, they'll think I'm incompetent'" tells them the method, the target and the goal it serves. Include homework you reviewed, psychoeducation you gave, skills you taught or practiced, referrals you discussed and any coordination of care.
Response
How the client responded to each intervention during the session: what they said, ratings before and after, a skill they practiced, anything they declined. BIRP has no separate Assessment section, so this is also where a one or two sentence clinical reading belongs ("suggests the first exposure step is the right size").
Plan
What happens next, written so you can check it next week. Homework with a number and a time frame, what you will do in the next session, referrals or coordination, the next session's date and format, and which treatment plan goal stays active.
A BIRP note template you can copy
Paste this into your notes, delete what you don't need, and keep the order. The header lines are what most payers and auditors look for before they read the clinical content.
For telehealth, the client's location matters because your license is tied to where the client is during the session. Many payers also want the format (video or audio only) recorded.
BIRP note example 1: individual telehealth session for work anxiety
Invented client: a 34-year-old accountant we'll call Dana, in her fourth session of CBT for anxiety that has led her to avoid meetings at work.
- Date of service: 10/14, 10:00 to 10:53, session 4
- Individual psychotherapy by video; client at home in Ohio, private room confirmed
- Treatment plan goal 1: reduce avoidance of work meetings and emails
Behavior: Client logged in on time and confirmed she was alone. Reported anxiety at 7/10 on most workdays this week and said, "I rewrote one email four times before I sent it." Skipped Tuesday's team meeting. GAD-7 score 12 (14 at intake). Spoke quickly for the first ten minutes and picked at her sleeve while describing her manager; pace slowed later in the session. Denied thoughts of harming herself or others when asked.
Intervention: Reviewed the thought record assigned last session (two of five entries completed). Used Socratic questioning to test the thought "If I make a mistake, they'll think I'm incompetent." Built the first three steps of a graded exposure list for work situations with the client. Practiced paced breathing for four minutes.
Response: Client found one piece of evidence against the thought ("My last review said my work was careful") and rated her belief in it at 60%, down from 90% at the start. Chose "send an email after one read-through" as the first exposure step, expected distress 4/10. Said the breathing "took the edge off" and rated anxiety 5/10 at the end. Partial homework completion and good engagement suggest the tasks are the right size but need a reminder.
Plan: Client will send two emails after a single read-through before next session and log distress before and after each. Continue thought records, aiming for four entries. Next session in one week by video: review the exposure log and move to step two. Goal 1 continues.
Why this note works:
- Behavior holds facts and quotes, not conclusions. "Anxious" never appears without a rating or something you could see.
- Each intervention in I has a matching line in R.
- The measure is compared with an earlier score, which shows progress without a paragraph of explanation.
- The Plan can be checked next week: two emails, four entries, step two.
BIRP note example 2: when the intervention does not work
Most examples online show a client who improves. Real weeks are not always like that, and an honest note protects you and the client better than an optimistic one.
Invented client: a 58-year-old retired teacher we'll call Ray, in his seventh session of behavioral activation for depression, seen in the office.
Behavior: Client arrived ten minutes late and said, "I didn't do any of it. There's no point." Activity log not completed. Spoke slowly and quietly with long pauses; posture slumped; affect flat throughout. Reported sleeping 10 to 11 hours most days and turning down two invitations from his sister. PHQ-9 total 17 (14 two weeks ago); item 9 scored 0. Denied thoughts of suicide or self-harm when asked directly.
Intervention: Explored what got in the way of the planned activities, without judgment. Cut the activity plan from five activities to one: a ten-minute walk after lunch. Used motivational interviewing to connect the walk to his stated value of "being someone my grandkids can count on." Reviewed the rise in his PHQ-9 score with him and raised a medication review with his primary care physician.
Response: Client said the original plan "felt like a mountain" and called the single walk "maybe doable." Engagement stayed low: short answers, and he did not offer ideas of his own. Declined a referral for a medication review today, saying he wanted "to try one more month." The rising score and low engagement suggest the earlier plan was too large; progress toward goal 2 has stalled.
Plan: Client will take a ten-minute walk on at least three days and mark each one on a card. Therapist will repeat the PHQ-9 next session. If the score rises again, functioning drops, or he reports thoughts of suicide, reassess risk, raise the medication review again and consider more frequent sessions. Next session in one week, in the office. Goal 2 continues with the smaller activity plan.
Why this note works:
- Response says plainly that the intervention did not land, and the Plan changes because of it.
- The declined referral is recorded with the client's own reason. If anyone reviews this chart later, they'll see the option was offered.
- The note says what would change the plan, so next week's decision is already framed.
BIRP note example 3: a couples session
Invented couple: partners we'll call Lee and Morgan, in their fifth joint session for repeated arguments, seen in the office.
Behavior: Both partners arrived on time. Lee described an argument on Sunday about weekend plans: "It always ends with me giving in." Morgan crossed his arms and looked away while Lee spoke, then interrupted twice. Both described the argument as raised voices, with no threats or physical contact; safety at home was screened with each partner individually at intake.
Intervention: Mapped Sunday's argument as a pursue and withdraw cycle with the couple. Coached a speaker and listener exercise in which each partner summarized the other's point before responding. Taught a time-out plan: a 20-minute break with an agreed time to come back to the conversation.
Response: Morgan summarized Lee's point accurately on the second try and said, "I didn't know it felt like that for you." Lee's voice softened and she named one thing Morgan does that helps. Both agreed to the time-out plan; Morgan was unsure he would remember to use it. Both partners can name the cycle; using the new skills at home is the next test.
Plan: The couple will use the time-out plan at least once and each write down what set it off. Practice the speaker and listener exercise for ten minutes twice this week. Next joint session in one week, in the office. Couple goal 1 (fewer escalating arguments) continues.
Where does a joint-session note go? That depends on who your intake and consent forms name as the client. Some therapists keep one record for the couple; others write a note in each partner's record. Either way, describe both partners evenly, follow the confidentiality policy in your consent forms, and write as if both of them may read it.
The same session as DAP and SOAP
Here is Dana's session from example 1 in the two other formats you're most likely to meet. The facts are identical; only where they live changes.
As a DAP note
Data: Client logged in on time by video, alone at home. Reported anxiety 7/10 on most workdays and skipped Tuesday's team meeting; "I rewrote one email four times before I sent it." GAD-7 12 (14 at intake). Rapid speech early, slowing later. Denied thoughts of harm to self or others. Reviewed thought record (two of five entries). Used Socratic questioning on the thought "If I make a mistake, they'll think I'm incompetent"; belief fell from 90% to 60%. Built three steps of a graded exposure list; client chose sending an email after one read-through as step one (expected distress 4/10). Practiced paced breathing; anxiety 5/10 at the end.
Assessment: Work-related anxiety remains moderate, kept going by avoidance of meetings and repeated checking. Client engages well with cognitive work and the GAD-7 has improved since intake. Partial homework suggests the task size is right but needs reminders. Gradual progress toward goal 1.
Plan: Two emails after a single read-through before next session, with distress logged. Thought records, aiming for four entries. Next session in one week by video: review exposure log, move to step two.
As a SOAP note
Subjective: "I rewrote one email four times before I sent it." Client reports anxiety 7/10 on most workdays and skipped Tuesday's team meeting. Completed two of five thought record entries. Denies thoughts of harm to self or others.
Objective: Logged in on time by video, alone at home. Rapid speech and picking at her sleeve early, slowing later. GAD-7 12 (14 at intake). Belief in the target thought fell from 90% to 60% during cognitive work; anxiety 5/10 at the end after paced breathing.
Assessment: Moderate work-related anxiety kept going by avoidance and checking; good engagement; gradual progress toward goal 1.
Plan: Continue CBT weekly by video. Graded exposure step one: two emails after a single read-through, with distress logged. Thought records, aiming for four entries. Next session: review the log and move to step two.
What changes between the three
- Where your techniques go.BIRP gives your interventions their own section. DAP folds them into Data; SOAP leaves them implied or moves them into Plan.
- Where your clinical reading goes.DAP and SOAP have an Assessment section. In BIRP, it is the last line of Response.
- How the client's words are split.SOAP separates what the client reports (Subjective) from what you observe (Objective). BIRP and DAP keep them together.
- What a reviewer sees first.BIRP opens with the presentation and makes the intervention and its effect easy to find. SOAP opens with the client's own account.
BIRP, DAP, SOAP or GIRP: which one to use
- Choose BIRP when your work is technique-led (CBT, DBT skills, behavioral activation, exposure) and you want every note to show what you did and whether it worked.
- Choose DAP when you want the shortest structured note and your clinical reading matters more than any single technique.
- Choose SOAP when you work alongside medical providers or a team that already uses it, or when separating the client's report from your observations matters.
- Choose GIRP when sessions are organized around treatment plan goals and you want each note to open with the goal you worked on.
- Whichever you choose, stay consistent for each client. Payers and auditors care about what the note contains, not which letters it uses.
Words to use in each section
This is the part of a BIRP note cheat sheet most people actually need: words that are specific, observable and quick to write.
Behavior: write what you saw
- Instead of "client was anxious," write "client spoke quickly, picked at her sleeve and rated anxiety 7/10."
- Instead of "client was resistant," write "client declined the role-play and said, 'I don't see the point.'"
- Instead of "client was in a good mood," write "client smiled when greeting, made steady eye contact and rated mood 7/10."
- Instead of "client was depressed," write "affect flat, spoke slowly with long pauses, PHQ-9 17 (14 two weeks ago)."
- Instead of "client did the homework," write "completed four of five planned activities and brought the log."
- Affect: flat, restricted, tearful, bright, irritable, anxious, labile, congruent or incongruent with content.
- Speech: rapid, pressured, slow, soft, loud, monotone, hesitant, normal rate and volume.
- Engagement: arrived on time or late, logged in from a private room, attentive, distracted, guarded, open, gave short answers.
Intervention: name what you did
- Verbs that work: reviewed, explored, reflected, validated, reframed, challenged, modeled, role-played, practiced, taught, assigned, assessed, screened, referred, coordinated, provided psychoeducation on.
- CBT: Socratic questioning, thought record, cognitive restructuring, behavioral experiment, graded exposure, activity scheduling.
- DBT skills: diary card review, chain analysis, distress tolerance skills, opposite action, interpersonal effectiveness role-play.
- Motivational interviewing: open questions, reflective listening, decisional balance, elicited change talk, values exploration.
- ACT: values clarification, defusion exercise, acceptance and willingness work, committed action planning.
- Relational and psychodynamic work: explored the pattern in current relationships, linked it to earlier experiences, reflected the process in the session.
- Couples work: mapped the interaction cycle, coached speaker and listener roles, taught a time-out plan.
Response: show the effect
- "Rated anxiety 7/10 before and 5/10 after the exercise."
- "Named two alternatives to the thought without prompting."
- "Practiced the skill twice in session; needed prompting the first time."
- "Partially completed homework (two of five entries)."
- "Declined the role-play; agreed to try it next session."
- "Engagement increased when the plan was linked to her stated goal."
- "Did not respond to the intervention; plan revised below."
Plan: make it checkable
- A number and a time frame: "two emails before next session," "three walks this week."
- Your next step: "review the exposure log and move to step two."
- Session details: "next session in one week by video."
- Goal status: "goal 1 continues," "goal 2 revised," "goal 3 met."
- Referrals and coordination, with the client's decision: "referral to PCP offered; client declined for now."
- A trigger for change: "if the PHQ-9 rises again, reassess and consider more frequent sessions."
How long a BIRP note should be, and how to write one in 10 minutes
For a 45 to 60 minute outpatient session, most BIRP notes run about 150 to 350 words: a few sentences per section. Intake, crisis and complex sessions need more. Longer is not safer; a note a reviewer can read in a minute is easier to defend than a transcript.
A routine that keeps most notes under ten minutes:
- In the last three to five minutes of the session, agree on the plan with the client out loud. That becomes your Plan section.
- Right after the session, jot down three things you observed and one quote. That is most of Behavior.
- Write Intervention next. You know what you did; name each technique in a few words.
- Write Response against each intervention, then add one line of clinical reading.
- Run the 60-second check below, then sign. Write it the same day when you can.
Common BIRP note mistakes
- Interpretation in Behavior."Client was manipulative" is a conclusion. Describe what happened and let the reader see it.
- Generic interventions."Provided supportive therapy" could describe any session. Name the technique and what it targeted.
- A Response that doesn't match the Intervention.If you list three techniques, the reader should find a response to each one.
- A vague Plan."Continue to monitor" isn't a plan. Say what the client will do, what you will do and when you'll next meet.
- No link to the treatment plan.Each note should show which goal the session served.
- Copying last week's note.Notes that read the same every week suggest nothing changed, or that nobody looked closely.
- Missing session details.Date, start and end time, format and who attended belong on every note, especially if you bill insurance.
- Writing for yourself only.Shorthand, nicknames and private reactions belong elsewhere, if anywhere. The client may read this note.
A 60-second check before you sign
- Could a colleague picture the session from Behavior alone?
- Is every label backed by a quote, a rating or something you saw?
- Does every intervention have a named technique and a response?
- Did you record a risk screen when you did one, and what the client said?
- Is there a clinical reading at the end of Response?
- Does the Plan include a number, a time frame and the next session?
- Is the treatment plan goal named?
- Are the date, start and end time, format and, for telehealth, the client's location there?
- Would you be comfortable if the client read it?
How this works in TranqBay
TranqBay is practice software for therapists in private practice: booking, video sessions, session notes and a practice website in one place. Here is where a BIRP note fits.
- Choose BIRP for the session. When you add a note to a session, you pick its format: BIRP, DAP, SOAP, GIRP, or a blank note in your own words. BIRP gives you the four headed sections.
- A prompt under each heading. Behavior asks what the client did and said in the session, Intervention the techniques you used, Response how the client responded, and Plan the next steps, homework, referrals and next session focus.
- The session details sit beside the note. A panel next to the note shows the session's date and time, duration, modality and therapy, the client's presenting concerns and the note they left when booking, so you are not retyping them.
- The note stays with the session. A finished session has an add-note link and lists its notes with their format, so last week's Plan is easy to find before this week's session.
- Structured formats such as BIRP are part of the advanced note templates, which some plans include.
To see how a session note sits next to the booking and the video session, look at the walkthrough on practice.tranqbay.health.
Frequently asked questions about BIRP notes
What does BIRP stand for?
Behavior, Intervention, Response, Plan. Behavior is what the client said and did, Intervention is what you did, Response is how the client responded, and Plan is what happens next.
What is the difference between BIRP and SOAP notes?
SOAP (Subjective, Objective, Assessment, Plan) separates the client's own account from your observations and gives your clinical reading its own section. BIRP keeps the account and observations together in Behavior and gives your interventions their own section. The worked example above shows the same session in both.
Are BIRP notes accepted by insurance?
Payers generally don't require a particular format. They look for content that supports medical necessity: the date, start and end time, who attended, the clinical problem, what you did, how the client responded, and a plan tied to treatment goals. BIRP covers all of this well. Check your payer contracts for their own documentation rules.
Can BIRP notes be used for group therapy?
Yes. Describe the group's focus and your interventions once, then write Behavior and Response for each member in that member's own record. Refer to other members without names or identifying details.
How soon after a session should I write a BIRP note?
As soon as you can, ideally the same day, while details are fresh. Your state board, payer contracts or practice policy may set a deadline. If you add a note late, mark it as a late entry with the date you wrote it.
Can clients read their BIRP notes?
Usually, yes. Under HIPAA, clients have a right to access their record, and progress notes are part of it. Only psychotherapy notes kept separately from the record are excluded (45 CFR 164.524). State law can add rules, for example for minors.
Is a BIRP note a psychotherapy note under HIPAA?
No. A BIRP note records the session's times, the modality, symptoms, the plan and progress, which HIPAA's definition of psychotherapy notes leaves out. It is a progress note and part of the record. Whatever software stores your notes should sign a Business Associate Agreement with you; you can read TranqBay's Business Associate Agreement before you store anything.
What is the difference between BIRP and GIRP notes?
GIRP opens with the treatment plan Goal the session worked on instead of the client's Behavior. Intervention, Response and Plan are the same. GIRP suits goal-led work; BIRP suits sessions where the client's presentation changes from week to week.
Before your next session
Copy the template, write your next note with the 60-second check beside you, and compare it with example 1. After three or four notes, the format stops feeling like a form and starts saving you time.
If you also want booking, video sessions and session notes in one place, see how TranqBay works for private practice: you can look at a practice website template and the booking steps your clients would go through. If you're deciding whether to join, this page explains how joining TranqBay works.
Sources
Regulations 2Associations 2
Laws and regulations2
- 145 CFR 164.501: definition of psychotherapy notes (eCFR)ecfr.govhttps://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.501
- 245 CFR 164.524: right of access to protected health information (eCFR)ecfr.govhttps://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.524
Professional associations2
- 3American Counseling Association, 2014 ACA Code of Ethics, standard A.1.bcounseling.orghttps://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-code-of-ethics.pdf
- 4American Psychological Association, Record Keeping Guidelinesapa.orghttps://www.apa.org/practice/guidelines/record-keeping