The template
Client: [identifier your setting uses] Date of service: [date] Start and end time: [00:00 to 00:00] Session type: [individual / couple / family / group; in person or telehealth] Telehealth (optional): [client's location this session; video or audio only] Service code: [if you bill] Clinician: [name, credentials] Treatment-plan goal addressed: [ ] B (Behavior) - What the client reported (concerns, symptoms, events since last session): [ ] - What you observed (presentation, affect, engagement): [ ] - Risk: reported and observed: [ ] I (Intervention) - What you did, named specifically (technique or approach): [ ] - Which goal it addressed: [ ] R (Response) - How the client responded during the session: [ ] - Progress toward the goal: [ ] P (Plan) - Next session focus and interventions: [ ] - Homework or practice agreed: [ ] - Referrals, coordination or safety-plan updates: [ ] - Next appointment and frequency: [ ] Signature, credentials, date: [ ]
What goes in each section
Behavior is the client's presentation: what they reported and what you observed. Some settings use "B" for the presenting problem as well. Keep it factual.
Intervention is what you did. Name it: "cognitive restructuring of the thought 'I always mess up'" tells a reviewer far more than "provided support". Tie it to a treatment-plan goal.
Response is how the client responded to the intervention during the session. Did they engage, resist, practice the skill, shift their rating? Record observable change, such as a shifted rating or a skill practiced.
Plan is what comes next: interventions, homework, referrals, safety steps and the next appointment.
Three filled examples
All examples on this page are fictional composites. They do not describe real clients.
1. Adolescent, school anxiety, in person, 45 minutes. Goal 1: attend school five days a week.
B: Client, 15, attended 3 of 5 school days. Reports stomach aches and "dread" on Sunday nights and Monday mornings. Restless, avoided eye contact early in session, more engaged later. Denies thoughts of self-harm. I: Reviewed the anxiety thermometer and identified physical signs of anxiety. Taught and practiced diaphragmatic breathing. Began a graded exposure plan for the school morning routine. Addresses Goal 1. R: Client rated anxiety 7 of 10 at the start and 4 of 10 after breathing practice. Identified two steps of the morning routine as the hardest. Agreed to the first exposure step with some hesitation. P: Exposure step 1: get dressed and eat breakfast by 7:30 on school days. Practice breathing nightly. Parent check-in by phone before next session; agreed with the client what will be shared. Next session in one week.
Rules on minors' consent to treatment and what a parent may be told vary by state. Check the rules where you practice.
2. Adult, alcohol use, telehealth, 50 minutes. Goal 2: reduce drinking to two days a week.
B: Client reports drinking on 4 of 7 days, down from 6, mostly after work, about 4 standard drinks on each drinking day. Says "it's how I switch off." Alert, cooperative, gave shorter answers when discussing amounts. Denies withdrawal symptoms and suicidal ideation. I: Motivational interviewing: reflected ambivalence, explored the client's own reasons for change, used importance and confidence rulers. Addresses Goal 2. R: Client named two reasons to cut down (sleep, mornings with their kids). Rated importance 7 of 10 and confidence 5 of 10; said a walk after work would raise confidence. Shifted from "maybe" to "I want to try Monday to Thursday off" by the end of session. P: Client's plan: no drinking Monday to Thursday this week; walk after work as a replacement. Log drinks daily. Review the log next session in one week. If withdrawal symptoms appear while cutting down, client to seek medical care promptly. Given recent heavy drinking, recommended a primary care visit to review drinking and health. Discuss medical consultation if drinking increases.
3. Adult, emotion regulation, in person, 50 minutes. Goal 1: use a skill instead of acting on self-harm urges.
B: Client reports two strong urges to self-harm this week after arguments with a family member; did not act on either. Tearful when describing the second argument. Denies suicidal ideation, plan or intent. I: Chain analysis of the second urge. Reviewed and practiced distress tolerance skills (cold water, paced breathing). Updated the safety plan. Addresses Goal 1. R: Client identified the moment the urge started and one point where a skill could have been used. Practiced paced breathing and reported the urge would have dropped "from an 8 to maybe a 5." Agreed to the updated safety plan. P: Use the distress tolerance plan when urges reach 6 of 10 or higher. Track urges and skill use on the diary card. Copy of the safety plan, including the 988 Suicide and Crisis Lifeline, given to client. Next session in one week.
Common mistakes
- A vague Intervention. "Supportive counseling" alone does not show what you did. Name the technique.
- Response that describes the week, not the session. The Response section is about how the client responded to today's intervention.
- No goal named. BIRP notes read best when each intervention ties to a treatment-plan goal.
- Risk asked but not recorded. Record what you asked and what the client said, including no.
- A Plan with no next step. Name the homework and the next appointment.
BIRP, SOAP or DAP
BIRP puts the intervention and response at the center. SOAP separates the client's report from your observations, and DAP combines them into one Data section. The BIRP vs SOAP vs DAP guide compares all three.
FAQ
What does BIRP stand for?
Behavior, Intervention, Response and Plan. It records the client's presentation, what you did, how they responded and what comes next.
What is the difference between BIRP and SOAP notes?
SOAP centers on the client's report and your observations and assessment. BIRP centers on your intervention and the client's response to it, which makes the link to treatment-plan goals easy to see.
What counts as an intervention in a BIRP note?
Anything you did with clinical purpose: a named technique such as cognitive restructuring or exposure, psychoeducation, skills practice, safety planning or a structured exercise. Name it specifically.
Do BIRP notes include an assessment?
Not as a separate section. Your clinical judgment shows in the Response and Plan sections. Some settings add an assessment line; follow your setting's template.
This page is educational. Adapt the template to your licensing board, your payer and your setting.
Reframe Practice is a tool for licensed therapists, not a therapy clinic or counseling service.