A PIRP note records a session in four parts: the Problem from the treatment plan that the session worked on, your Intervention, the client’s Response, and the Plan. Copy the free template, see a brief CBT for insomnia example and a couple session after an alcohol lapse, and check what goes in each part.
Blank PIRP note template
FreePIRP NOTE Client: [Name or ID, date of birth] Session date: [Date] Time: [Start, end, and total minutes] Session type: [Individual, couple, family, or group; session number in this episode of care, such as 4 of 6] Format and place: [In person at the office, or video or phone with the client's location] Participants: [Everyone who took part, by role, or client only] Clinician: [Name, credentials] Diagnosis on the plan: [Working diagnosis, and the date the plan was agreed] PROBLEM Plan problem addressed: [Problem number and its wording on the treatment plan] Linked objective: [The objective for this problem, its measure, target, and target date] How it shows now: [Current symptoms or behaviors: how often, how strong, and what has changed since last session] Plan measure: [Today's rating, log total, or score, beside the baseline] Client's account: [In the client's words, what has been hardest with this problem lately] Why care is still needed: [What the problem is doing to work, sleep, home, health, or safety] Other problems raised: [Anything new, and whether it belongs on the plan, or none] INTERVENTION Approach: [The model in use: CBT, motivational interviewing, behavioral couples therapy, solution-focused, problem-solving, or other] What was done: [Each technique by name, and what it involved today] Aimed at: [The problem and objective each technique targets] Homework set: [Tasks agreed, and how the client will track them] Coordination: [Contacts with prescribers, family, or other services, and the consent for each] RESPONSE In session: [Engagement, understanding, and any skill shown or practiced] Presentation: [Mood in the client's words, affect, behavior, thought process] Result: [The plan measure now, beside the baseline and the target] Problem status: [Resolved, improving, unchanged, or worse, and the evidence] Safety: [What you asked about suicide, self-harm, harm to others, and substance use; the answers; your judgment] Barriers: [What got in the way of homework or change] PLAN Before next session: [What the client will do, and how they will record it] Clinician actions: [Calls, letters, or referrals, each with a date] Next session focus: [The problem and technique to take up next] Plan changes: [Changes to the problem list, objectives, frequency, or level of care, or none] End point: [Sessions left, or the result that will close this problem] Next appointment: [Date, time, and format] Clinician signature: [Name, credentials, date and time]
Use it for
Each one follows the template. Use them to judge how much detail every part needs.
Primary care behavioral health, brief CBT for insomnia, session 4 of 6, 30 minutes
Session 4 of 6 of brief CBT for insomnia with the clinic’s behavioral health clinician, in person, 30 minutes. Client only. 44-year-old woman, a civil engineer promoted to project lead 9 months ago; drives 35 minutes to work. Referred by her family physician: STOP-Bang 1, normal thyroid tests, no sleep medication. Diagnosis on the plan: insomnia disorder, persistent, with night waking. Plan agreed at session 1.
Problem 1: “Wakes around 3 a.m. most nights and can’t get back to sleep,” for 8 months, since the promotion. Objective 1a: sleep efficiency of 85% or more on her sleep diary, and an Insomnia Severity Index below 8, by session 6. Baseline at session 1: 8 hours in bed, about 5 hours 20 minutes asleep, efficiency 67%, ISI 20. Sleep window of 12:45 to 6:15 a.m. since session 2. This week: night waking on 3 of 7 nights, 2 of them before Thursday’s client design review. In her words: “I’m sleeping more solidly, but the 3 a.m. to-do list still shows up before a deadline.” Impact: heavy afternoons in site meetings, and 2 drawing errors last month that she puts down to tiredness. Other problems raised: none.
Worked out the week’s sleep efficiency with her from the diary. Sleep window titration: efficiency was 90% or more, so the window grows by 15 minutes; bedtime moves to 12:30 a.m., and the 6:15 a.m. wake time stays fixed, weekends included. Stimulus control for deadline nights: if awake about 20 minutes or her mind is racing, get up, sit in the living room in low light, and go back to bed only when sleepy. Cognitive restructuring of “if I sleep badly, the review will go badly,” using last Thursday as evidence. Set up a constructive worry routine at 7:30 p.m.: 15 minutes writing tomorrow’s concerns, one next step for each, then closing the notebook. The titration and stimulus control target the night waking; the worry routine and belief work target the waking before deadlines.
Diary complete for 7 of 7 nights; she did the arithmetic herself. Mood “tired but hopeful”; affect bright; thought process logical. This week: about 5 hours 5 minutes asleep in a 5-hour-30-minute window, efficiency 92%, from 87% last week and 67% at baseline. Awake in the night 18 minutes on average, from 110 at baseline. ISI 13, from 20, now in the subthreshold range. Epworth Sleepiness Scale 8, from 11 at session 2; no drowsiness while driving this week. Got out of bed on 1 of 3 wakings; on the 2 nights before the review she stayed in bed about 40 minutes, reading email on her phone. Slept about 4 and a half hours before the review, and it went well. Belief rated 80% at the start and 35% at the end. Problem 1 improving: objective 1a met for efficiency, not yet for the ISI. Safety: PHQ-9 5. Denies thoughts of suicide or self-harm. No evening alcohol since session 1, as agreed; no caffeine after noon. Barriers: the phone by her bed, and deadline weeks.
Window of 12:30 to 6:15 a.m. for 7 nights, with the diary each morning. Phone charges in the kitchen overnight. Worry routine at 7:30 p.m. on workdays. Out of bed after about 20 minutes awake, deadline nights included. No driving when drowsy; she will call the clinic if daytime sleepiness rises. Clinician: score the new diary at the start of session 5. Next session focus: one more window step if efficiency stays at 90% or more, then a relapse plan for deadline weeks and work travel. Plan changes: none. End point: 2 sessions left; Problem 1 closes when the ISI is below 8 and efficiency holds at 85% or more. With her consent, a summary to her family physician after session 6. Next appointment in 1 week, in person.
Outpatient addiction program, behavioral couples therapy, session 6 of 12, 60 minutes
Conjoint session 6 of 12 of behavioral couples therapy, in person, 60 minutes, alongside his weekly individual counseling in the same program. 51-year-old man, an electrician, and his wife of 24 years. Each partner seen alone for 10 minutes first, then together. Diagnosis on his plan: alcohol use disorder, moderate. Naltrexone 50 mg daily from his primary care clinician since September.
Problem 3 on his plan: “Arguments and broken trust at home linked to drinking.” Before treatment they argued most days, and his wife was thinking about separating. Objective 3a: the daily trust discussion on 6 of 7 days, and no more than 1 argument about drinking a week, for 4 weeks in a row, by session 10. Linked to Problem 1, alcohol use. On Saturday, at his nephew’s wedding, he drank about 8 beers over 5 hours, after 63 days without alcohol; his wife drove them home. On Sunday she found he had stopped naltrexone a week before the wedding. In his words: “I thought I could have two and stop.” In hers: “The drinking scared me less than finding the pills.” Past 7 days: trust discussion on 2 days, from 7 of 7 in the 3 weeks before; 5 arguments about drinking, from 1 the week before. Relationship ratings out of 10: his 5 and hers 3, from 7 and 6 at session 4. She will stay in couples work, but not “if there’s more hiding.”
Separate check-ins first. Asked each partner alone about pushing, hitting, threats, damage to property, and fear at home, now or ever. Asked him alone about thoughts of suicide or self-harm since the wedding. Together: went through the lapse as information, not a verdict, from stopping naltrexone to the open bar and the plan to leave by 9 p.m. that he skipped. Restarted the recovery contract with one change: he takes naltrexone in front of her at breakfast, during the trust discussion, where he states his intention not to drink that day, she thanks him, and neither brings up past drinking. Speaker-listener practice on the hidden pills: she spoke for 3 minutes, and he summed up what he heard before replying. Wrote a plan for his work holiday party on December 12. Each picked one shared activity for the weekend. With his written consent, messaged his primary care clinician about the lapse and the stopped naltrexone.
She was tearful in her check-in and guarded at first together; he was quiet, and apologized without a prompt. His mood “ashamed,” hers “worn out”; thought process logical in both. He summed up her point correctly on the second try, and she said, “That’s the first time I’ve felt heard about the pills.” Breath alcohol 0.00 today. No alcohol since Saturday by both accounts; no shakes, sweats, or broken sleep since. He restarted naltrexone on Monday and agreed to take it in front of her. Party plan: arrive at 7, drive himself, a soda in hand, text her at 8, and leave by 9. Ratings at the end: his 6, hers 4. Problem 3 worse since the lapse, but both chose to keep going. Problem 1: a single lapse, with no drinking from the next day on. Safety: neither partner reports violence or fear at home; he denies thoughts of suicide, self-harm, or harming others. Judgment: low risk; outpatient care and couples work remain suitable. Barriers: his belief that he can “just have a couple” at events, and her checking the recycling bin, which he finds shaming.
Both: trust discussion and witnessed naltrexone at breakfast each day, ticked on the kitchen calendar; save talk about past drinking for sessions. Him: party plan on the fridge; individual session Thursday. Her: bring worries to the trust discussion or to session instead of checking the recycling, for 1 week as a trial. Shared activity: a hike on Sunday. Clinician: update his individual counselor at Thursday’s team meeting; follow up with the primary care clinician by Friday. Next session focus: Problem 3, noticing and naming each other’s caring acts, and a review of the party. Plan changes: witnessed naltrexone added to the recovery contract; objective 3a target moved from session 10 to session 12. End point: 6 couples sessions left. Next appointment Wednesday at 6 p.m., in person.
The facts of the session, and the plan it belongs to. PIRP notes often go to reviewers, so make the link to the plan easy to find.
Avoid: Leaving out the session number in short-term work. “Session 4 of 6” tells the next reader how far along the problem is.
The treatment plan problem this session worked on, and how it shows up now. This is what sets PIRP apart: the note opens with the difficulty being treated, in the plan’s words, followed by today’s evidence that it still needs care.
Avoid: A diagnosis in place of the problem. “Insomnia disorder” is the label; “wakes at 3 a.m. on 3 of 7 nights” is the problem, and it can change from week to week.
What you did about that problem, in enough detail that a colleague could run the next session.
Avoid: “CBT techniques used.” Name the technique, such as stimulus control or a speaker-listener exercise, and the problem it served.
What changed, measured against where the problem started, and what got in the way.
Avoid: “Client responded well.” Put the number beside the baseline, and say whether the problem itself has moved, not only the mood in the room.
The next steps on this problem, and when the work on it should end.
Avoid: An open-ended plan for a short-term problem. Say what will close the problem, so progress can be judged against it.
“Discussed sleep” could describe any session. Name the problem by number and in the plan’s words, so a reviewer can match the service to the plan.
When one session works on two problems, say which technique served which. Otherwise no one can tell what the session was for.
A sleep or skills problem still needs a short safety screen. A lapse, a fight at home, or weeks of short sleep can change risk; ask, and record the answers.
PIRP suits time-limited work, but only when the note says what done looks like. Give the sessions left, or the result that will close the problem.
Say whose plan the session serves, who was present, and whether you saw anyone alone. Record a partner’s words only as far as they bear on the client’s problem.
Vero Scribe writes the PIRP 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.
Problem, Intervention, Response, and Plan. Problem is the treatment plan problem the session addressed, and how it shows up now. Intervention is what you did about it. Response is how the client responded, measured against where the problem started. Plan is what happens next, and when the work on that problem should end.
Name the problem by number and in the plan’s words, then give today’s evidence: how often, how severe, the plan’s measure, and the client’s own account. Record each technique and the problem it targeted. Then give the client’s response with a number beside the baseline, a short safety screen, and any barriers. Finish with the client’s tasks, yours, the next focus, and the end point.
The first heading is the difference. SOAP separates what the client reports from what you observe, and DAP puts both in Data before your Assessment. BIRP opens with the behavior you observed today, GIRP with the goal the client is working toward, and SIRP with a recent event or circumstance. PIRP opens with the problem on the treatment plan that the session addressed. BIRP, GIRP, SIRP, and PIRP share their last three headings.
When the treatment plan is a list of problems and the work is focused and time-limited: brief CBT, solution-focused therapy, and problem-solving therapy. It also suits substance use counseling, where plans often list problems such as use, cravings, and conflict at home, and records an insurer or auditor reviews, where each session must show which problem it treated and why care is still needed. It works for couple and family sessions too, when the note says whose plan the session serves.
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.
Where the numbered problems and objectives a PIRP note names come from.
Counseling notes and plans drafted from your sessions, for you to review.
Session notes drafted from your sessions, for you to review.
Session examples in three common note formats, side by side.
Vero writes your notes and letters in the templates you choose, so you review instead of type.
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