What is a BIRP note?
Quick answer
BIRP notes are a structured progress-note format used by mental-health and behavioral-health professionals to document a treatment session in four sections: Behavior, Intervention, Response, and Plan. Behavior captures the client's presentation and reported symptoms, Intervention records what the clinician did during the session, Response describes how the client reacted, and Plan outlines the next steps and follow-up. The format is especially common in community mental health, substance-use treatment, and case management.
Why the BIRP format exists
BIRP evolved in community mental health and substance-use settings where billing auditors want to see what the clinician did, not just what the client said. The Intervention and Response sections force the writer to document therapeutic action and its immediate effect, a structure that aligns well with evidence-based practice documentation.
When to use BIRP notes (and when not to)
Use BIRP for substance-use treatment, behavioral health in community settings, Applied Behavior Analysis (ABA) and case management, where you need to show the intervention and its immediate outcome. Some programs and managed care organizations prefer a BIRP-style structure at intensive outpatient or partial hospitalization levels of care, so check your own requirements. For sessions that are mostly narrative talk therapy, a DAP note may be simpler.
The BIRP note structure
BIRP notes follow a four-part structure: Behavior, Intervention, Response, Plan. Each section answers a different clinical question.
Behavior
Client’s presentation: what they said, did, showed up with. Include affect, observed symptoms, reported events between sessions. Example: "Client reported 4 panic attacks this week. Arrived appearing anxious, pressured speech. GAD-7 = 15."
Intervention
What you did this session. Name the technique. Example: "Reviewed trigger log; psychoeducation on panic cycle and interoceptive cues; practiced diaphragmatic breathing in-session; collaboratively developed exposure hierarchy."
Response
How the client reacted to your interventions. Example: "Client engaged actively in psychoeducation; verbalized understanding of panic cycle. Rated in-session anxiety decreasing from 7/10 to 4/10 after breathing exercise. Agreed to exposure homework with stated ambivalence."
Plan
Next steps. Example: "Continue weekly CBT. Begin interoceptive exposure next session. Homework: breathing 2x/day, panic log. Next session in one week."
BIRP note template
Copy this blank template into your record system or word processor and replace each prompt in brackets. Prefer a document? Download the Word version.
Client: [initials or record number] · Date of service: [date] · Session: [individual, couples, family or group; length; in person or telehealth]
B: Behavior
Client report: [presenting concerns, symptoms and events since the last session, in the client's words where useful]
Observations: [appearance, affect, behavior, engagement]
Measures: [scores such as PHQ-9 or GAD-7, if given]
Risk screening: [what you asked and how the client answered]
I: Intervention
Interventions used: [name each technique, such as CBT, motivational interviewing or skills practice]
Focus: [the treatment goal or problem addressed]
Homework or materials reviewed: [what you went over together]
R: Response
Client response: [engagement, statements, skills demonstrated, change within the session]
Progress: [movement toward each treatment goal, with evidence]
P: Plan
Next session: [date or interval, and focus]
Homework: [between-session tasks]
Referrals or coordination: [who and why]
Treatment plan changes: [if any]
BIRP note examples
Two complete BIRP notes. Both are fictional: the clients, scores and details are invented for teaching. Adapt the structure to your own sessions rather than copying the text.
Example 1: Individual session, anxiety with panic symptoms
Scenario (fictional): 45-minute individual outpatient session with an adult client, 6 weeks into CBT for generalized anxiety with panic features.
Behavior: Client arrived on time, well-groomed, affect anxious with pressured speech when describing workplace stressors. Reports 4 panic attacks this week (baseline 1-2), worst Tuesday after critical work email. General anxiety rated 8/10. Sleep 4.5 hrs/night due to rumination. Sertraline 100mg adherent. Completed 2 of 7 homework diary entries. GAD-7 = 15 (severe), PHQ-9 = 9. Denied SI/HI.
Intervention: (1) Reviewed panic log entries with client; identified Tuesday email as activating cognition "my work is slipping and I'll lose this job." (2) Provided psychoeducation on the panic cycle and interoceptive cues. (3) Led diaphragmatic breathing exercise in-session. (4) Introduced rationale for interoceptive exposure; collaboratively drafted a 6-item exposure hierarchy from least to most distressing. (5) Reinforced safety plan and medication adherence.
Response: Client engaged actively in psychoeducation and verbalized understanding of the panic cycle ("so the physical sensations aren't dangerous, but my brain interprets them that way"). In-session anxiety decreased from 7/10 pre-breathing to 4/10 post-breathing. Agreed to 2x/day breathing and one panic-log entry per episode. Verbalized ambivalence about interoceptive exposure ("what if it makes the panic worse?") but committed to psychoeducation review before next session. No acute distress observed.
Plan: (1) Continue weekly CBT. (2) Begin interoceptive exposure next session with reinforced psychoeducation. (3) Homework: 10-min diaphragmatic breathing 2x/day; panic-log entry per episode with trigger/intensity/duration. (4) With the client's signed release, contact PCP about an SSRI dose review. (5) Safety plan unchanged. (6) Next session in one week.
Example 2: Community outpatient session, alcohol use
Scenario (fictional): 45-minute individual session in a community outpatient program with an adult client working on alcohol use, session 8.
Behavior: Client arrived on time, tired but well groomed. Reports drinking on 2 of the last 7 days (5 of 7 at intake), 3 to 4 drinks each time, both after arguments at home. Rates evening cravings 6/10. Attended one mutual-support meeting this week. Denies withdrawal symptoms. Denies suicidal ideation and thoughts of harming others. Affect frustrated when discussing conflict at home; cooperative throughout.
Intervention: (1) Used motivational interviewing to explore the client's reasons for change and ambivalence about evening routines. (2) Reviewed both drinking episodes with a functional analysis of trigger, thoughts, behavior and consequences. (3) Practiced urge surfing in session. (4) Updated the relapse-prevention plan with the client.
Response: Client identified arguments at home as the main trigger and said, "If I leave the house for a walk, the urge passes." Rated craving falling from 6/10 to 3/10 by the end of the urge-surfing exercise. Agreed to call a support contact before drinking. Remains ambivalent about attending more than one meeting a week.
Plan: (1) Continue weekly individual sessions. (2) Homework: log cravings and responses daily; use the walk-and-call plan after conflict at home. (3) Attend at least one mutual-support meeting. (4) Discuss a joint session with the client's partner, with the client's consent. (5) Review the relapse-prevention plan next session. (6) Next session in one week.
MentalNote drafts BIRP notes in this structure from your recorded session. Check every line against the session and your own observations before you sign.
How MentalNote drafts a BIRP note
The BIRP note generator runs in the MentalNote web app at app.mentalnote.ai. MentalNote is HIPAA-compliant, with a BAA included on every plan.
- Choose BIRP as the note format. Start a recording and pick BIRP from the Note format menu (SOAP is the default). Choose In the room or Telehealth call and confirm you have your client's consent. The first time, you accept the Business Associate Agreement in the app.
- Record, then generate. When the session ends, stop the recording and generate the note. MentalNote transcribes the audio and drafts the Behavior, Intervention, Response and Plan sections. Nothing is transcribed live during the session.
- Check it against the transcript. The transcript is labeled by speaker. Correct anything that's off and add what the recording couldn't capture, such as observations you didn't say aloud.
- Refine with Edit with AI. Ask for changes like "Make it more concise" or "More clinical language". It only makes changes the transcript or your note supports, and you accept or discard each one.
- Copy or print. Copy the whole note or one section, with formatting or as plain text, or print it and save a PDF. Then paste it into your record system.
Working in Microsoft Word? The MentalNote Word add-in drafts a BIRP note from a session summary you type or paste when you ask for the BIRP format. It's set up to keep to the details you give it and to mark missing information as not provided rather than guess.
See a BIRP draft before you sign up
Open the fictional sample session, choose BIRP in the Format menu, and edit, copy or print the prepared note. No account needed.
Try it with a sample session, no signupReady for your own sessions? Sign up free: 5 web-app scribe sessions a month, no credit card. Premium is $99/month or $990/year.
BIRP note templates by diagnosis, setting and modality
Each guide below shows a BIRP note adapted to that clinical situation. Use them as a starting point, then edit and adapt the note to your client.
Mood & Anxiety Disorders
- BIRP Notes for Depression
- BIRP Notes for Major Depressive Disorder
- BIRP Notes for Bipolar Disorder
- BIRP Notes for Bipolar II Disorder
- BIRP Notes for Anxiety
- BIRP Notes for Generalized Anxiety Disorder
- BIRP Notes for Panic Disorder
- BIRP Notes for Social Anxiety Disorder
- BIRP Notes for Phobias
- BIRP Notes for Specific Phobia
- BIRP Notes for OCD
- BIRP Notes for Hoarding Disorder
Trauma, PTSD & Grief
Substance Use & Addiction
Personality & Behavioral
Child, Adolescent & Family
- BIRP Notes for ADHD
- BIRP Notes for Attention-Deficit / Hyperactivity Disorder
- BIRP Notes for Autism Spectrum Disorder
- BIRP Notes for Children
- BIRP Notes for Adolescents
- BIRP Notes for Children & Adolescents
- BIRP Notes for Families
- BIRP Notes for Family Systems Therapy
- BIRP Notes for Couples
- BIRP Notes for Couples Therapy
- BIRP Notes for Perinatal Clients
- BIRP Notes for Perinatal Mental Health
Specialty Populations
Therapy Modalities
- BIRP Notes for CBT
- BIRP Notes for DBT
- BIRP Notes for ACT
- BIRP Notes for EMDR
- BIRP Notes for Internal Family Systems (IFS)
- BIRP Notes for Schema Therapy
- BIRP Notes for Psychodynamic Therapy
- BIRP Notes for Humanistic Therapy
- BIRP Notes for Interpersonal Therapy
- BIRP Notes for Narrative Therapy
- BIRP Notes for Solution-Focused Therapy
- BIRP Notes for Motivational Interviewing
- BIRP Notes for Mindfulness-Based Therapy
- BIRP Notes for Somatic Therapy
- BIRP Notes for Somatic Experiencing
- BIRP Notes for Art Therapy
- BIRP Notes for Play Therapy
Frequently asked questions
What is a BIRP note?
A BIRP note is a progress note format that documents a session in four sections: Behavior, Intervention, Response and Plan. It records the client's presentation, what you did, how the client responded and the next steps.
Can I try the BIRP note generator without signing up?
Yes. The sample session at app.mentalnote.ai/try opens a fictional encounter with a prepared draft. Choose BIRP in the Format menu, then edit, copy or print the note, with no account. Because it uses prepared examples, it doesn't record audio or run the live AI model.
How does MentalNote write a BIRP note from a session?
Choose BIRP as the note format, record the session with your client's consent, and generate the note when you stop. MentalNote transcribes the recording and drafts the Behavior, Intervention, Response and Plan sections for you to review and edit. In the Word add-in, you can type or paste a session summary and ask for a BIRP note instead.
When should I use BIRP instead of SOAP or DAP?
BIRP puts your intervention and the client's response at the center of the note. That suits settings where reviewers want to see what the clinician did and how the client responded, such as community mental health, substance-use treatment and case management. Use the format your organization or payer expects.
Is BIRP accepted by insurance?
BIRP is a widely used progress note format. Payers, Medicaid programs and accrediting bodies can set their own documentation requirements, so check them before you standardize on any format.
What is the difference between a BIRP note and a psychotherapy note?
A BIRP note is a progress note and belongs in the client's clinical record. Psychotherapy notes are a clinician's separate process notes with extra protection under HIPAA: disclosing them generally requires the client's specific authorization under 45 CFR 164.508(a)(2). Keep them separate from progress notes.
Is MentalNote HIPAA-compliant?
Yes. MentalNote is HIPAA-compliant, with a BAA included on every plan, including the free plan. You accept the Business Associate Agreement in the app before your first session.
How much does MentalNote cost?
The free plan includes 5 web-app scribe sessions a month, with no credit card. Premium is $99/month or $990/year. A BAA is included on every plan.
Can I use the BIRP template instead of the generator?
Yes. The template on this page is free to copy and fill in by hand, and there is a Word version. Use the generator when you want a first draft written from the session itself.
Related generators and guides
- AI SOAP note generator: draft Subjective, Objective, Assessment and Plan from a recorded session.
- DAP note generator: Data, Assessment and Plan, with a template and examples.
- AI therapy notes: how MentalNote handles every note format in one workflow.
- PIRP note generator: Problem, Intervention, Response and Plan, with a template and examples.
- BIRP notes guide: a longer walkthrough of the format.
- BIRP notes for substance use, BIRP notes for community mental health and BIRP notes for anxiety.
Further Reading
- DSM-5-TR (APA): diagnostic criteria used in clinical documentation.
- APA Record-Keeping Guidelines: national standards for psychologists’ clinical records.
- HIPAA Privacy Rule: federal rules on progress notes and psychotherapy notes.