A BIRP note records a session in four parts: the client’s Behavior, your Intervention, the client’s Response, and the Plan. Copy the free template, see a group home skills session and a third session of CBT for panic attacks, and check what goes in each part.
Blank BIRP note template
FreeBIRP NOTE Client: [Name or ID] Date: [Date of service] Time: [Start and end time, total minutes] Service: [Individual therapy, skills session, group, family session, or case management contact] Setting: [Office, group home, residential unit, school, home, or video, with the client's location if remote] Present: [Client only, or each person by role] Plan goal served: [Goal and objective by number, worded as on the current treatment plan] Staff: [Name, credentials, role] BEHAVIOR Client's report: [What the client said about the target behavior or symptoms since the last session, with a short quote] Counts and logs: [Frequency from the client's diary, a staff log, or incident reports, beside the previous count] Others' reports: [What staff, family, or other providers described, with who said it and over what period] Seen today: [Appearance, eye contact, speech, activity, and how the client engaged] Mood and affect: [Mood in the client's words; affect as you saw it] Thinking and perception: [Thought process, and any voices, unusual beliefs, or intrusive thoughts the client describes] Scores: [Any measure given today, beside the last result] Risk screen: [Suicidal thoughts, self-harm, harm to others, and substance use: the questions and the answers] INTERVENTION Approach: [The model or service: CBT, skills training, DBT skills, motivational interviewing, psychoeducation, or case management] Steps taken: [Each technique by name and what it involved, in the order used] Target of each step: [The behavior or objective each step was aimed at] Help given: [Prompts, modeling, script cards, handouts, or other changes to fit the client] Contacts: [Calls or messages to staff, family, or providers, and the consent for each] RESPONSE Participation: [How the client took part, and anything offered and declined] Skill shown: [What the client did in session, and how many prompts or tries it took] Before and after: [Ratings, counts, or scores at the start and the end, or beside the baseline] Client's view: [What the client said about the session, in their words] Progress on the objective: [Met, progressing, unchanged, or worse, with the evidence] Clinical impression: [Your judgment of what today's behavior and response mean, and your risk judgment] PLAN Client tasks: [Practice or steps before the next session, how often, and how they will be tracked] Staff and provider tasks: [Who will do what, and by when] Supports: [Prompts, staff support, safety plan, or the crisis line 988, call or text] Next session: [Date, time, setting, and focus] Plan changes: [New or revised goals, frequency, or level of care, or none] Signature: [Name, credentials, date and time signed]
Use it for
Each one follows the template. Use them to judge how much detail every part needs.
Supervised group home, psychosocial rehabilitation skills session, 45 minutes
Individual skills session, 45 minutes, in the quiet room of a supervised group home for 6 adults, his choice of room. Client only. 34-year-old man with schizophrenia, in the home for 3 years and planning a move to a supported apartment in about 3 months. Works 3 mornings a week at a thrift store through a supported employment program. Medicines: aripiprazole every morning, and metformin with breakfast and supper, from a pharmacy blister pack kept in a lockbox in his room. Goal 2: “Look after my own medicines before I move.” Objective 2a: take both daily doses on his own at the set times, with staff only checking the log, on 6 of 7 days for 4 weeks in a row, by February 1.
Self-administration log and house staff notes, past 7 days: evening doses taken on his own at about 8 p.m. on 6 of 7 days, up from 4 the week before. Morning doses on his own on 2 of 7 days; the other 5 taken after the staff prompt at 8:30 a.m. No missed doses. In his words: “The night ones are easy. In the morning I sleep through the alarm.” House manager’s report: he stayed in his room most of Saturday and Sunday after his brother cancelled a visit, but came down for meals and did his Sunday chores. Seen today: on time, shaved, in his work T-shirt. Eye contact fair; speech soft and normal in rate, with short pauses before answers. Mood “a bit flat since the weekend”; affect restricted, livelier when he talked about pricing donated records at work. Thought process goal-directed. Hears a mumbling voice most evenings, which he rates 3 out of 10, his usual level, with no commands. Sleeping about 9 hours, unchanged. Risk screen: denies thoughts of suicide, self-harm, or harming anyone. Denies alcohol and cannabis.
Skills training for medicine self-management: tell, show, do, and review. Went through the log with him on a 2-week chart, marking his own doses in green and prompted doses in yellow. Problem-solving on mornings: he listed 3 options and chose 2, moving his phone alarm across the room onto the lockbox, and adding a second alarm 10 minutes after the first. Linked the morning dose to breakfast, which he eats every day at 7:45. Teach-back on each medicine: what it is for, when he takes it, and what to do about a missed dose. Role-played a refill call to the pharmacy twice, with a script card. Talked about the cancelled visit, named the disappointment with him, and planned a call to his brother.
Took part throughout, and chose the alarm plan himself. Teach-back correct for both medicines without help: aripiprazole “keeps the voices down,” and metformin “is for my sugar, with food.” Needed one prompt on missed doses, then said: “Check the log, then ask staff or the pharmacist. Don’t double up.” Refill role-play: on the first try he read the card word for word and left out his date of birth; on the second he gave his name, date of birth, and both medicines without looking. Confidence in doing mornings alone 5 out of 10 at the start, 7 at the end. Objective 2a progressing: 8 of 14 doses on his own this week, from 6, not yet at the target. Impression: his medicine knowledge and evening routine are solid; mornings are a waking problem, not a knowledge problem. The quiet weekend reads as disappointment about his brother. His sleep, voices, self-care, and meals are unchanged, so no sign of early relapse. Risk low.
He will set both alarms tonight, starting at 7:30 a.m., take his morning dose with breakfast, and mark the log himself. He will call his brother on Wednesday after supper about a new visit date. Morning staff keep the 8:30 a.m. prompt time, no earlier, and note each day whether a prompt was needed. Counselor: give the house manager and morning staff the alarm plan today, and send the 2-week chart to his psychiatrist before the medication review on December 2. Next session Monday at 2 p.m.: a real refill call to the pharmacy, with the script card as backup. No change to the plan; objective 2a review on December 15.
Outpatient group practice, individual CBT in person, session 3 of 12, 50 minutes
Session 3 of a planned 12 sessions of CBT for panic disorder, in person, 50 minutes. Client only. 38-year-old man who runs the service department at a car dealership. First panic attack 4 months ago in a checkout line at a big-box store; 2 emergency visits since, each with a normal ECG and blood tests. His family physician’s workup, including a 24-hour Holter monitor, was normal. Carries 2 lorazepam tablets left from the first emergency visit; none taken in 3 weeks. Goal 1: “Stop panic from running my life.” Objective 1a: no more than 1 full panic attack a week for 4 weeks in a row, by his panic diary, by session 12. Objective 1b: do the family’s weekly grocery shop at a large store without leaving early, by session 10.
Panic diary kept on 6 of 7 days: 3 full attacks and 2 limited-symptom attacks this week, from 4 full attacks last week. Peak fear 7 or 8 out of 10, each attack over within about 15 minutes. Worst on Tuesday, in a pharmacy line. Has not been inside a large store since September; his partner does the shopping. Sits at the end of a row at his daughter’s school events. Checks the heart rate on his smartwatch “maybe 40 times a day.” In his words: “I know the tests were normal, but in the moment I’m sure this is the one.” Seen today: on time, casually dressed; checked his watch twice in the first 10 minutes and jiggled his right leg while describing Tuesday. Speech normal in rate. Mood “on edge”; affect anxious, and he laughed once at his own story of rushing to the car. Thought process logical. Panic Disorder Severity Scale 17, from 18 at intake. PHQ-9 6. Risk screen: denies thoughts of suicide, self-harm, or harming others. 2 or 3 beers on Saturdays, unchanged; no other drugs.
CBT for panic disorder, cognitive model. Drew his panic cycle together from Tuesday’s attack: a warm, crowded line; noticing his heart pounding; the thought “this is a heart attack,” believed 90% at the time; fear; a faster heart, a tight chest, and tingling hands; then leaving the line, sitting in his car, and checking his pulse, which read 128. Explained the fight-or-flight response, why fear speeds up the heart, and why an attack peaks within minutes and passes on its own. Listed his safety behaviors: watch checks, sitting near exits, carrying the lorazepam, leaving lines, and keeping a water bottle in hand. Went through how each one stops him learning that the symptoms pass without it. Behavioral experiment: 60 seconds of fast, deep breathing while standing, after confirming he has no asthma or seizure history and that his workup was normal. He took off his watch and left it on the desk. Rated his anxiety, how much the sensations felt like his attacks, and his belief that “a racing heart means a heart attack,” before and after.
Brought his diary without a prompt and engaged throughout. Once shown the first half of the cycle, he drew the rest himself. Over-breathing brought on dizziness, tingling hands, and a pounding heart, 7 out of 10 like his attacks. Anxiety rose to 6 out of 10 and was back to 2 within 4 minutes, with no watch check and without leaving the room. Belief that a racing heart means a heart attack: 85% before, 50% after. In his words: “So breathing alone can do all that.” Agreed to stop the watch checks this week. Declined to leave the lorazepam at home yet: “Maybe after the store.” Objective 1a not met: 3 full attacks against a target of 1 or fewer, though down from 4. Objective 1b not started. Impression: a typical early response. He understands the model in the room, but during an attack the heart attack belief stays high, kept up by the watch checks and the tablets he carries. Risk low.
He will keep the diary daily, adding his belief rating and any safety behavior he used. Over-breathing for 60 seconds once a day at home, with the same 3 ratings. Heart rate display and alerts off on his watch, and the watch in a drawer after 6 p.m. He keeps the lorazepam for now and will log any use. Chest pain that is new or unlike his attacks, such as pain that comes on with exertion or lasts longer than his attacks do, means calling 911. Therapist: with his consent, send his family physician a short update on the CBT plan and the tablets he carries, before his visit next week. Next session: build an exposure ladder, from a pharmacy line at a quiet hour up to the weekly shop. No change to the plan. Next session in 1 week, same time, in person.
The facts of the contact, and the treatment plan goal it served, so the note can be matched to the plan.
Avoid: Leaving out the setting. In group homes and residential programs, where the session took place and who else was there matter to the next reader.
What the client reported and what you saw at the start of the session, with something you can count. This is what sets BIRP apart: the note opens with the client’s behavior, not with a plan goal, a problem, or an event.
Avoid: A mood word with nothing to compare. “Anxious” could describe any week; “3 full panic attacks, from 4” shows which way things are going.
What you did, in the order you did it, and how much help the client needed to take part.
Avoid: A model name on its own. “CBT” or “skills training” names the approach; name the step, such as an over-breathing experiment or a pharmacy role-play.
What the client did with each intervention, a number to compare, and what you make of it. BIRP has no Assessment heading, so your clinical judgment goes at the end of this part.
Avoid: Writing only the good news. Record what took two tries, what the client declined, and what didn’t change, so the next session starts from where things really are.
The client’s next steps, everyone else’s, and the next session, written so whoever reads it next can act on it.
Avoid: Changing what staff or family do without saying who will tell them. Name the person who passes the plan on, and when.
“Noncompliant,” “attention-seeking,” and “resistant” say what you concluded, not what happened. Write the action, the time, and the count, such as “took his morning dose after the 8:30 a.m. prompt on 5 of 7 days.”
In residential and team settings, much of Behavior comes from other people. Say who reported it and over what period, such as “evening staff log, past 7 days,” so a reader can tell a staff count from the client’s memory.
In anxiety work, checking a pulse, carrying a pill, or sitting by the exit can look like coping. Record them as behaviors to track and reduce, because they keep the fear going.
When the plan changes how staff prompt or support a resident, say who will tell them and when. Otherwise the next shift carries on the old way, and the note doesn’t match what happens.
A settled resident, or a client who is “only” having panic attacks, still gets a short risk screen. Ask each session, and put the questions and answers in Behavior.
Vero Scribe writes the BIRP note in your template from the session, with the client’s consent, or from your dictation afterward. You review and edit every section, then copy it into your record or export it to Word or PDF. Vero works in 60+ languages.
Behavior, Intervention, Response, and Plan. Behavior is what the client reported and what you saw at the start of the session, with any counts or scores. Intervention is what you did. Response is what the client did with it, and your judgment of progress and risk. Plan is the next steps, and who takes them.
Open with the client’s behavior: their own account, any counts from a diary or staff log, what others reported, what you saw, and the risk questions with their answers. Name each intervention and what it was aimed at. Then record what the client did with it, how much help it took, a number before and after, and your impression. Finish with tasks for the client and for everyone else, and the next session.
Both what the client tells you and what you see, labeled so a reader can tell them apart. Add counts from a diary, staff log, or incident reports, and what family, staff, or other providers said, with the source. Include a brief presentation, today’s scores, and the risk screen. Describe actions, not labels: “left the line and sat in his car,” not “avoidant.”
The opening section. BIRP starts with the client’s behavior. GIRP starts with the treatment plan goal, PIRP with a problem from the plan, and SIRP with the event behind the contact; all four end with Intervention, Response, and Plan. SOAP splits the client’s report from your observations and adds an Assessment. DAP puts report, observation, and what you did together under Data, then your Assessment.
Yes. Copy it, or download it as a Word or text file. No account needed.
One psychotherapy session: focus, interventions, client response, risk, and progress toward goals.
A CBT session in its own order: mood check, agenda, homework review, thought or exposure work, new homework, and feedback.
An EMDR session by phase: target, negative and positive cognitions, SUD and VOC, bilateral sets, closure, and reevaluation.
Data, Assessment, Plan: the three-part session note, with the line between facts and judgment made clear.
Goal, Intervention, Response, Plan: a progress note that opens with the treatment plan goal.
The longer guide: four more worked sessions, checking a note against its source, payer rules, and a checklist before you sign.
Where the goals and numbered objectives a BIRP note reports on come from.
Progress notes drafted from your sessions, for you to review.
One session written three ways, side by side.
Vero writes your notes and letters in the templates you choose, so you review instead of type.
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