BIRP Notes for Child and Adolescent Therapy: Example and Template
How to write a BIRP note for a child or teen therapy session: what to document under Behavior, Intervention, Response and Plan, a fictional adolescent example, and answers to common questions about parents, consent and safety.
Quick Answer
A child or adolescent BIRP note records four things. Behavior: what the child or teen said, what the caregiver or school reported (each attributed) and what you observed. Intervention: the developmentally adapted technique you used and its purpose. Response: how the young person responded, measured where you can. Plan: what the young person, the caregiver and you will do next. Keep each source separate and link the session to a treatment-plan goal.
Overview
This guide is part of our complete BIRP notes hub — format structure, a full clinical example, the BIRP note generator, and all 72 diagnosis-specific templates.
No sign-up needed: open a fictional BIRP note in the MentalNote editor and edit it like a real draft.
Notes for children and teens differ from adult notes in three ways: information comes from several people (the young person, caregivers, sometimes the school), interventions are adapted to developmental level, and consent, confidentiality and mandated-reporting rules apply. The table shows what goes in each BIRP section.
What to document in a child or adolescent BIRP note
| BIRP section | What to document | Example wording |
|---|---|---|
| Behavior | Who attended and for how long; the young person’s report in their own words; caregiver or school report, attributed | “Client (age 14) attended alone; parent joined for the last 10 minutes. Client said: ‘We argue every night about my phone.’ Parent reported 4 arguments this week (6 the week before).” |
| Behavior | What you observed: affect, engagement, how the young person related to you | “Arms folded and brief answers for the first 10 minutes; more talkative once the client chose the topic.” |
| Intervention | The technique, how it was adapted to age, and why | “Used a thoughts-feelings-actions worksheet with a recent argument as the example, to support the goal of fewer arguments at home.” |
| Response | What the young person did with it, with a rating where possible | “Identified the thought ‘they never listen’; rated anger 7/10 recalling the argument and 4/10 after planning a response.” |
| Response | Safety and mandated-reporting screening | “Asked privately about self-harm, suicidal thoughts and feeling unsafe at home: denied all. No reportable concerns.” |
| Plan | What the young person, the caregiver and you will do; what will be shared and on what basis | “Client to try the planned request once. With the client’s agreement, phone rules to be discussed at a joint session next week.” |
Who can consent to a minor’s treatment, what a teen can keep confidential and what parents or guardians can see differ by state, and sometimes by type of service. Document what you explained to the young person and the caregiver about confidentiality and its limits at the start of treatment.
How to Document BIRP Notes for Child & Adolescent Therapy
Behavior
Document observable client behaviors, actions, and presentation in session
When documenting Behavior for a child or adolescent, capture the client's self-reported symptoms, current presenting concerns, observed triggers, and notable mood or affect during the session to provide a clear picture of their emotional and behavioral state.
- Client reports feelings of anxiety, sadness, or irritability since the last session
- Observed behavioral triggers such as peer conflict, academic stress, or family tension
- Description of mood fluctuations or affect changes during the session (e.g., tearfulness, withdrawal, agitation)
- Presentation of any somatic complaints or physical manifestations related to emotional distress
- Noted incidents of impulsivity, aggression, or withdrawal as expressed by the client or observed directly
Intervention
Record specific therapeutic interventions and techniques used
In the Intervention section for child and adolescent clients, document the specific therapeutic techniques, clinical observations, and modalities applied during the session tailored to the developmental level and presenting issues.
- Use of age-appropriate cognitive-behavioral strategies to address negative thought patterns
- Incorporation of play therapy or art therapy techniques to facilitate expression
- Application of relaxation or mindfulness exercises adapted for children/adolescents
- Clinical observations of engagement level and response to therapeutic activities
- Use of motivational interviewing to enhance readiness for behavior change
Response
Note the client's response to interventions and observable changes
Document the child's or adolescent's reaction to the interventions, clinical impressions regarding progress or setbacks, and any diagnostic considerations based on the session to guide ongoing treatment.
- Client demonstrated increased insight or verbalized understanding of coping skills
- Observed reduction or escalation in target symptoms compared to prior sessions
- Client showed resistance, avoidance, or reluctance during specific interventions
- Clinician’s impression of symptom severity or new diagnostic information emerged
- Noted improvements or challenges in mood regulation and social interactions
Plan
Outline next steps, continued interventions, and session scheduling
Outline the next steps tailored to the child or adolescent's needs, including homework assignments, treatment adjustments, referrals, and scheduling to support continued progress and engagement.
- Assign developmentally appropriate homework to practice coping or social skills
- Modify treatment approach based on response and emerging needs
- Schedule follow-up session with consideration of school and family availability
- Recommend referral to specialized services such as educational support or psychiatry
- Plan to involve family or caregivers in upcoming sessions for systemic support
BIRP note example for an adolescent client
Fictional documentation example, not treatment guidance. Adapt it to the session you actually conducted and your organization’s requirements.
Behavior: Fictional 14-year-old client, session 5; client attended individually and a parent (legal guardian) joined for the last 10 minutes. Treatment-plan goal: no more than 2 arguments at home a week. Client said: “We argue every night about my phone.” Parent reported 4 arguments this week (6 the week before). Client sat with arms folded and gave brief answers for the first 10 minutes, then talked more freely once he chose the topic.
Intervention: Used a thoughts-feelings-actions worksheet with Tuesday’s argument as the example. Role-played a calm way to ask for more phone time. Before the joint part, agreed with the client which points would be shared with the parent; in the joint part, gave brief psychoeducation on predictable house rules.
Response: Client identified the thought “they never listen to me,” rated anger 7/10 recalling the argument and 4/10 after planning a response, and practiced the request twice. Parent agreed to try a written phone agreement. Asked privately about self-harm, suicidal thoughts and feeling unsafe at home: client denied all. No reportable concerns identified.
Plan: Client will use the planned request once this week. Client and parent will each bring ideas for a phone agreement to a joint session next week. Next session in one week, with 15 minutes joint, to review the number of arguments.
See a note like this in the editor: open a prepared fictional BIRP note in MentalNote, no sign-up. For your own sessions, the BIRP note generator drafts the note from a recorded session for you to review and edit.
Tips for BIRP Notes for Child & Adolescent Therapy
1. Attribute every source
Label what the young person said, what the caregiver reported and what the school reported, and keep each separate from what you observed. Note when information came by phone or email and whether an authorization was needed.
2. Record consent, assent and confidentiality limits
Note who holds the right to consent, that the child or teen assented, and what you explained about confidentiality and its limits. Rules on minors consenting to their own treatment and on parental access differ by state.
3. Say how you adapted the intervention
Write the technique, how you adapted it to the young person’s age (visual, play-based, shorter steps) and the goal it served. When you interpret play or drawings, label it as your clinical impression rather than fact.
4. Measure the same way over time
If you use a standardized measure such as the SDQ, SCARED or CBCL, record the score, the date and who completed it (young person, parent or teacher), and repeat it at set points. Do not paste the items into the note.
5. Write with record access in mind
Parents or guardians can often request a minor’s records, subject to state law and exceptions. Record what is clinically necessary, keep private disclosures to what the note needs, and follow your state’s rules on access and on care a minor consented to.
6. Document disclosures and reports precisely
If a child discloses possible abuse or neglect, record the child’s words, the context, who was present, the report you made (agency, date and time, reference number) and any consultation. Mandated-reporting rules differ by state.
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Further Reading
- APA Documentation Guidelines — Provides detailed guidance on clinical documentation practices relevant to mental health professionals.
- SAMHSA — Offers resources and best practices for behavioral health documentation and treatment planning.
- NIMH (National Institute of Mental Health) — Contains research and clinical information on child and adolescent mental health useful for informed documentation.