Clinical Template

BIRP Note Template and Examples

Last updated: October 2, 2026

Reviewed by the WellNotes Clinical Team

Type or dictate a quick session summary. Get a complete BIRP note, linking behaviors to interventions and outcomes, in under 2 minutes.

What is a BIRP Note template?

A BIRP note template has four sections: Behavior (the client's presentation and what they reported), Intervention (what you did), Response (how the client responded) and Plan (next steps). Because it links each intervention to an observed response, BIRP is common in community mental health, substance use treatment and other settings that track outcomes closely.

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What are BIRP Notes?

BIRP notes are a behavior-focused clinical documentation format that emphasizes observable client behaviors, the specific interventions used by the clinician, the client's response to those interventions, and the plan moving forward. This format is particularly valued for its clear connection between clinical actions and outcomes.

The BIRP structure is especially useful for demonstrating medical necessity to insurance companies and managed care organizations. By explicitly linking behaviors to interventions and documenting measurable responses, BIRP notes create a clear clinical narrative that supports reimbursement and treatment justification.

Many state licensing boards and agency settings prefer or require BIRP-style documentation because it provides accountability for clinical decision-making. The format is widely used by licensed professional counselors, clinical social workers, and behavioral health providers working with diverse populations.

BIRP Note Template Structure

Use these 4 headings, in this order, for every birp note. Each card explains what belongs in the section.

Behavior

Observable client behaviors during the session: what the client said, did, and how they presented, including mood, affect, and specific behavioral indicators relevant to treatment goals.

Intervention

Specific clinical interventions the therapist employed during the session: therapeutic techniques, modalities used, psychoeducation provided, and skills taught.

Response

How the client responded to the interventions: observable changes in behavior, affect, or cognition during the session, and the client's engagement with therapeutic exercises.

Plan

Next steps in treatment: goals for the next session, homework assignments, frequency of sessions, and any modifications to the treatment approach.

BIRP Note Examples

4 filled examples for different sessions, written in the template above.

All examples are fictional and de-identified. They show structure and level of detail, not clinical advice for a real client.

BIRP Note Example 1: Depression (behavioral activation)

Adult client with moderately severe depressive symptoms, early in treatment.

Behavior: Client presented with flat affect and reported persistent feelings of worthlessness over the past two weeks. Made minimal eye contact initially. Stated "I don't see the point in trying anymore" when discussing job search efforts. Denied suicidal ideation when directly assessed. Reported sleeping 10-12 hours per day and withdrawing from social activities.
Intervention: Administered PHQ-9 (score: 16, moderately severe depression). Utilized behavioral activation framework to identify small, achievable daily activities. Conducted cognitive restructuring exercise targeting "I'm worthless" core belief: examined evidence for and against. Introduced activity scheduling worksheet. Provided psychoeducation on the depression-inactivity cycle.
Response: Client became more engaged during behavioral activation discussion. Eye contact improved. Identified three previously enjoyable activities (walking, cooking, calling friend). Was able to generate counter-evidence to worthlessness belief with prompting. Agreed to complete activity schedule for one week. Stated "maybe I can try the small stuff" by session end.
Plan: 1. Increase session frequency to weekly given symptom severity. 2. Client to complete daily activity schedule (minimum one pleasant activity per day). 3. Continue cognitive restructuring targeting core beliefs. 4. Reassess PHQ-9 next session. 5. If symptoms worsen, discuss psychiatric referral for medication evaluation. Next session: 1 week.

BIRP Note Example 2: Substance use (IOP group member)

Individual BIRP note for one member of an intensive outpatient relapse prevention group.

Behavior: Client attended the full 3-hour group session and arrived on time. Reported 21 days without alcohol use and one strong craving on Saturday after a family argument. Appeared alert, well groomed, with euthymic affect. Participated voluntarily twice.
Intervention: Facilitator led a relapse prevention module on identifying high-risk situations and used a chain analysis of a group member's recent craving. Prompted client to apply the urge-surfing skill to his Saturday craving.
Response: Client described the craving lasting about 20 minutes and said he called his sponsor instead of going to the store. Identified family conflict as his main trigger. Gave supportive feedback to a peer. Agreed to add one coping response for family conflict to his relapse prevention plan.
Plan: Continue IOP 3 days per week. Client to update his relapse prevention plan with a family conflict section and bring it to his individual session. Continue mutual support meetings as planned. Review cravings log at the next group.

BIRP Note Example 3: Adolescent anger (school-based)

13-year-old client seen in a school-based counseling program.

Behavior: Client referred by teacher after a shouting incident in class 2 days ago. Arrived with arms crossed and said "it wasn't my fault." Over the session became more talkative. Reported 2 times this week when he walked away from conflict. Denied thoughts of hurting himself or others.
Intervention: Reviewed the incident using a feelings thermometer to identify early anger cues. Practiced a 3-step calm-down plan (notice body cues, ask for a break pass, breathe) through role-play of a classroom scenario.
Response: Client identified clenched fists and a hot face as early signs. Completed the role-play twice and suggested using the break pass himself. Rated willingness to try the plan as 7/10.
Plan: Meet weekly during advisory period. With parent consent, share the calm-down plan with the classroom teacher. Client to track break pass use on a card. Review card and incident reports next week.

BIRP Note Example 4: Panic disorder (interoceptive exposure)

Adult client in CBT for panic disorder, session 6.

Behavior: Client reported 1 panic attack this week (previous week: 3). Still avoiding the gym because a fast heart rate "feels like the start of an attack." Appeared mildly anxious at start of session, speech normal, oriented. Panic Disorder Severity Scale: 11 (baseline: 16).
Intervention: Reviewed the panic cycle model. Conducted interoceptive exposure in session: 60 seconds of running in place and 30 seconds of breathing through a straw, with anxiety ratings before and after each trial.
Response: Peak anxiety 7/10 on the first running trial, 4/10 by the third. Client noted "my heart was racing and nothing bad happened." Completed all planned trials.
Plan: Continue weekly CBT. Client to repeat the running exercise daily and log ratings. Plan a 10-minute visit to the gym before the next session. Repeat PDSS in 2 weeks.

How to Write a BIRP Note

Behavior. Describe the client's presentation and report: mood, affect, relevant statements, observed behavior, measures and risk screening results.
Intervention. Name the specific techniques you used and what they targeted (for example, cognitive restructuring for a stated belief, exposure for an avoidance behavior).
Response. Document how the client responded to each intervention in observable terms: participation, skill demonstration, rating changes or statements.
Plan. Set next steps tied to the response: homework, next intervention, session frequency and when you will reassess.

Want a structured first draft to compare with your own? Try the free BIRP note generator with brief, de-identified session details.

Common BIRP Note Mistakes

Listing interventions without a matching Response, which breaks the link BIRP is meant to show.
Writing "client responded well" instead of the specific change you observed.
Using Behavior for interpretation ("client was manipulative") rather than describing what happened.
Plans that do not follow from the Response section.

How It Works

Three steps to a finished birp note

Describe the Session

Type a few sentences about what happened, or dictate with your voice. No special formatting needed.

WellNotes Structures Your Note

Your observations are organized into proper Behavior, Intervention, Response, and Plan sections using clinical language.

Review, Edit, and Sign

Read through the note, make any edits, then export as PDF or copy to your EHR. Done.

Documentation Before & After WellNotes

Before WellNotes

You spend the session focused on your client. Now you need to recall specific behaviors, document which interventions you used, and describe how the client responded, all in a structured format. 25 minutes later, you're still writing.

After WellNotes

Session ends. You type a few sentences about what happened. A complete BIRP note appears with behaviors linked to interventions and outcomes, formatted and ready to sign.

From 20+ minutes to under 2

Who Uses BIRP Notes?

CounselorsSocial WorkersLPCsBehavioral Health Providers

BIRP Note FAQ

What is an example of a BIRP note?

A brief BIRP example: Behavior, client reports one panic attack this week and avoids the gym; Intervention, interoceptive exposure with running in place; Response, anxiety fell from 7/10 to 4/10 across three trials; Plan, daily practice and a short gym visit before next session. Full examples for four scenarios are shown on this page.

How do you write a BIRP note?

Describe the client's presentation and report in Behavior, name the techniques you used in Intervention, record the observable result of each technique in Response, and set next steps in Plan. Make sure every intervention you list has a matching response.

What is a BIRP note in therapy?

A BIRP note is a four-section clinical documentation format that stands for Behavior, Intervention, Response, and Plan. It links observable client behaviors to the clinical interventions used and documents how the client responded. BIRP notes are popular in managed care and behavioral health settings because they clearly demonstrate the connection between clinical actions and outcomes.

What is the difference between BIRP and SOAP notes?

SOAP notes organize information by type (subjective vs. objective), while BIRP notes organize information by the clinical process (what the client did, what you did, how they responded, and what comes next). BIRP notes are often preferred by managed care organizations because they make it easier to demonstrate medical necessity and link interventions to outcomes.

When should I use BIRP notes instead of DAP or SOAP?

BIRP notes are ideal when your setting requires clear documentation of the link between client behaviors, your clinical interventions, and measurable outcomes. They are especially common in agency settings, managed care, and behavioral health programs where treatment accountability and outcome tracking are priorities.

Do insurance companies accept BIRP notes?

Yes. BIRP notes are commonly accepted by payers and are popular in managed care settings, though requirements vary by payer. The format explicitly documents medical necessity by linking client behaviors to clinical interventions and measurable responses, which is exactly what payers want to see.

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