BIRP stands for Behavior, Intervention, Response, and Plan. This progress note format emphasizes the client’s presentation, the clinician’s specific actions, the client’s response, and the next steps in treatment.
When BIRP Notes Are Helpful
BIRP notes are especially useful in behavioral health, substance use treatment, skills based care, and settings where documentation must clearly connect observable needs, therapeutic interventions, client response, and treatment goals.
BIRP Sections
Behavior (B)
Document the client’s presentation and the clinically relevant concerns addressed during the session.
Include:
- Reported symptoms, emotions, behaviors, and stressors
- Observable affect, engagement, speech, behavior, and functioning when relevant
- The primary session theme or treatment target
- Relevant risk or safety information when clinically indicated
Intervention (I)
Document what the clinician did during the session.
Include:
- Specific evidence based techniques, prompts, education, or skills used
- The purpose of each intervention
- Support, validation, assessment, problem solving, or care coordination provided
- How the intervention relates to the treatment plan
Response (R)
Document how the client responded to the interventions.
Include:
- Participation, engagement, understanding, or resistance
- Skills practiced or insights identified
- Observable change during the session
- Progress, barriers, and feedback from the client
Plan (P)
Document the next steps in treatment.
Include:
- Focus of the next session
- Skills, homework, or actions to practice
- Continued or modified interventions
- Follow up, referrals, coordination, or safety monitoring when relevant
Reusable BIRP Template
B — Behavior
Client reported [symptoms, concerns, behaviors, or stressors] and presented as [relevant observable information]. Session focused on [treatment target or functional concern].
I — Intervention
Therapist used [specific intervention, skill, or technique] to address [goal or clinical need]. Therapist also provided [education, validation, assessment, rehearsal, problem solving, or support].
R — Response
Client [level of engagement and response]. Client demonstrated [insight, skill use, progress, or barrier] and reported [relevant feedback or outcome].
P — Plan
Continue treatment focused on [goal or clinical need]. Client will practice [skill or action]. Therapist will use or revisit [planned intervention]. Next session will address [topic, goal, or monitoring need].
Brief Example
B — Behavior
Client reported increased cravings following conflict with a family member and identified isolation as a common response to distress. Client appeared tense but engaged and denied current intent to use substances.
I — Intervention
Therapist completed a trigger and response review, used motivational interviewing to explore reasons for change, and practiced an urge surfing strategy. Therapist helped the client identify supportive contacts and alternative coping responses.
R — Response
Client actively participated, identified two early warning signs, and stated that the urge surfing strategy felt realistic to use. Client expressed increased confidence in contacting a support person before acting on cravings.
P — Plan
Client will use the coping plan during increased cravings and contact one identified support when needed. Continue relapse prevention work and review the effectiveness of the plan at the next session.
Use factual, clinically relevant, and non-identifying language. Adapt this template to applicable laws, payer requirements, employer policies, professional standards, and the needs of the individual client.