A complete guide to PIRP notes (with example)

April 11, 2025
Outline
Alena Miklasova
Coach, & Therapist-in-Training, Upheal
Fact Checked by
Jeff Kashou
LMFT

Clinical documentation is an essential part of every therapist’s job.

Each session must be documented for legal, insurance, and clinical purposes to protect both client and therapist.

In this article, we’ll explore what PIRP notes are, when to use them, and how to write them. We’ll also share a PIRP note example from Grace Meyer on our Clinical team.

If you’re a little unsure about which progress notes to use, we recommend starting with our article comparing some of the most popular progress notes available.

And finally, we’ll provide a PIRP template that you can download for free.

What is a PIRP note?

PIRP notes are a progress note type used by mental health professionals such as psychotherapists, counselors, social workers, psychiatrists, and psychologists.

The PIRP note acronym stands for Problem, Intervention, Response, and Plan. Each of these sections is an essential component of the mental health PIRP note a practitioner has to write when using this particular note format.

The PIRP note components:

  • Problem (P): Describes the problem being faced by the client.
  • Interventions (I): Actions taken by the clinician in response to the behavior.
  • Response (R): Patient's reaction to the intervention.
  • Plan (P): Future treatment plan, follow-up actions, and next steps.

Writing notes in a PIRP format offers a structured picture of the client’s problem and their progress toward resolving it.

The PIRP note – a real-world scenario

Jeff Kashou, therapist and our Senior Clinical Product Lead, has picked the following scenario that’s well-suited to PIRP notes from his years in therapy practice.

Example: Using a PIRP note for a client who is struggling with self-harming behaviors.

The therapist will describe the problem first, capturing the client’s current difficulties.

They will then choose the most relevant interventions, in this case, psycho-education on the self-harm cycle, emotional regulation, and distress tolerance strategies, as well as a brief look at underlying triggers and cognitive distortions contributing to self-harm urges.

In the response section, the therapist will then capture the client’s thoughts and feelings that arose as a result of the interventions, such as the client being able to identify specific steps they would take in moments of distress, feeling less out of control, and more regulated by the end of the session.

In the plan section, the therapist documents any agreed-upon strategies, such as tracking self-harm urges and keeping a thought log or practicing at least one distress tolerance skill, as well as what will be addressed in the next session.

Patient PIRP note example – written by a therapist

Problem:

Client attended a scheduled session and reported experiencing increased urges to engage in self-harm over the past week, primarily in response to academic stress and conflict with parent. Client disclosed one instance of superficial cutting with a paperclip on their forearm three days ago. Client reported feelings of guilt and frustration after the incident and stated, “I didn’t want to do it, but I didn’t know how else to deal.” Client denied current suicidal thoughts, plan, or intent. Protective factors include a strong connection to their younger sister and a desire to complete their college education as motivations for staying safe. Risk factors include a history of self-harm and parental abuse. Client was able to contract for safety and agreed to utilize coping strategies before engaging in self-harm, stating “I really want to stop doing this, for my sister and for me too”.

Intervention:

Therapist provided psycho-education on the self-harm cycle, emotional regulation, and distress tolerance strategies. Therapist recommended alternative coping techniques, including the use of ice, rubber bands, and grounding exercises (e.g., 5-4-3-2-1 sensory awareness technique). Therapist prompted exploration of underlying triggers, including conflict with parent, and cognitive distortions contributing to self-harm urges. Client identified negative self-talk as a major factor and worked with the therapist to reframe thoughts. Therapist and client reviewed and revised client’s safety plan, reinforcing client’s access to crisis support resources (e.g., campus crisis text line, therapist emergency contact procedures).

Response:

Client stated, “I think having a plan makes me feel way less out of control,” and engaged actively in problem-solving exercises, nodding and making consistent eye contact. Client acknowledged the importance of alternative coping skills, and expressed a willingness to try at least one new technique before the next session. When reviewing the safety plan, client was able to identify specific steps they would take in moments of distress and stated, “I’m feeling hopeful, I think this may work well for me.” Client’s affect appeared more regulated by the end of the session.

Plan:

Client will track self-harm urges and coping strategies in a thought log for review in the next session. This was a client-generated idea, as they expressed a long-term interest in journaling. Client agreed to practice at least one distress tolerance skill before engaging in self-harm. Therapist will continue to assess risk levels at each session, incorporate structured safety check-ins, and modify interventions based on the client’s response. Client will utilize support systems or crisis resources as needed and has agreed to a check-in via email if distress levels escalate before the next session. The next session will focus on strengthening emotional regulation techniques and expanding coping strategies.

3 important benefits of the PIRP note template

Using the PIRP note template allows for heightened focus on a particular problem. This makes the PIRP note well-suited to more serious issues, such as self-harm, severe depression, and more.

  1. Highly problem-focused: PIRP notes are excellent at focusing on a particular client problem. This can range from managing the effects of neurodivergence to dealing with self-harm behaviors. The PIRP notes document the client's presenting problem in great detail, ensuring the clarity and specificity needed for a very targeted treatment approach.
  2. Allow for easy re-evaluation of progress: Using PIRP notes allows the focus of treatment to be evaluated and adjusted as needed so that precious time isn’t wasted on interventions that aren’t working. When using a mental health PIRP note, there is significant emphasis on the client's response to various interventions used, making tracking changes easy and flexible.
  3. Good for crisis intervention: PIRP notes are effective at crisis intervention because they specifically hone in on the problem or set of problematic behaviors the client is experiencing. The PIRP format structure allows you to remain organized and focused, ensuring that all necessary information is captured and any follow-up plans, referrals, or additional services are recorded.

PIRP note template pdf

Use our free PIRP note template for your client sessions – it’s free to download.

PIRP note template example

How to write a PIRP note – a step-by-step guide

Here’s our head therapist’s step-by-step guide using the PIRP acronym.💡 It’s a neat way to remember what you’re trying to capture in each section.

STEP 1

P: Probe into the problem

In this section, the focus is on capturing the client’s problem or problems as best you can. Gently find out why the client has decided to seek therapy. What symptoms are they experiencing, physically and emotionally? And how are their problems affecting their daily life? If you see a diagnosis, add it here, and note the level or intensity of their distress.

STEP 2

I: Intervene using clinical experience and judgment

This is where you, the therapist, decide on specific strategies or therapeutic interventions and implement them. In the Intervention section, you’ll find these verbs helpful: validated, encouraged, supported, role-played, modeled, prompted, recommended, taught, monitored, reviewed, and reinforced.

STEP 3

R: Response evaluation

In the Response section, take a moment to consider how the client responded to the methods you tried. Be sure to document what the client said and the way they reacted, including how they felt about the techniques used. Then, also capture whether the therapeutic intervention was effective or not. This is important as it can mean a re-evaluation of the intervention used or a simple direction of further progress and later interventions being used.

STEP 4

P: Plan the next treatment steps

The details around the next session, including the date and appointment time should all make up the Plan section, as well as what you will focus on. Add any homework your client was asked to work on and the interventions you’re planning to use next session. Your plan will always depend on what you uncover during the session, your client’s state and determination, including any change in goals. Make a note of any changes and the reasoning for the decision.

Your PIRP notes cheat sheet – the sections step by step

Here’s how to remember and understand PIRP sections in 4 easy steps.

  1. P: What is the problem the client is facing? What are the physical and emotional aspects?
  2. I: How did I, the therapist, intervene? What did I do to help the client with their situation?
  3. R: What was the client’s response to that? How well did it work or not? How did they feel?
  4. P: What’s the plan going forward in the next session(s)?

Common use cases for the PIRP note template

1. Crisis intervention

PIRP notes work well in situations requiring fast and precise documentation, such as crisis intervention or short-term therapy. Their structured format ensures that immediate concerns are addressed with clarity, making them particularly helpful in urgent therapeutic settings.

2. Shorter-term therapy

Since PIRP notes get right at the issue fast, they’re a great choice for when you know you have a specific issue to treat in a limited timeframe. In addition, they can be shared with other practitioners when you are working in a multidisciplinary team and only get to see a client for a few sessions, enhancing continuity of care.

3. Added compliance and accountability

Well-documented PIRP notes serve as legal protection for therapists, demonstrating adherence to ethical and legal standards, and supporting compliance with regulatory and insurance requirements.

4. Private practice or organization

Whether you work for yourself or in a larger organization, PIRP notes give a clear, organized format for documenting important aspects of therapy sessions, ensuring consistency and completeness across multiple sessions and providers, providing a shared understanding of a client's treatment plan and progress.

6 tips for writing excellent PIRP notes

  1. Be clear and specific: State the problem and or diagnosis concisely. Stay objective, avoiding personal judgements, or interpretations.
  2. Include additional, measurable context: Capture the duration and intensity of symptoms and previous treatments or conditions affecting the client’s experience.
  3. Capture the client’s perspective: Use quotes and include the client’s interpretations.
  4. Consider comorbidities: If there are interconnected medical conditions, add them to the problem statement. Describe the relationship to create a holistic understanding.
  5. Avoid jargon and acronyms: Use standardized terminology. Your shorthand won’t be familiar to all healthcare professionals, so it’s best to stick to terms everyone will know.
  6. Be timely: Writing your notes promptly makes all the difference when it comes to clinical accuracy, relevance, and insights. Try to do so within 48 hours, or have them done almost instantly with an AI note-taking tool like Upheal.
  7. Review changes over time: Make sure to review the client’s growth from a longer-term perspective, reflecting on their journey and challenges to arrive at new treatment ideas or simply celebrate the client’s growth.

Additional insights

Although clinical documentation is necessary, it doesn’t necessarily need to be time-consuming. Using a trustworthy automated platform like Upheal can speed up the process greatly.

And it’s not just about the speed – although saving you time for yourself or other clients is absolutely something we strive for, we’re keen to also support various aspects of psychotherapy to empower and support clinician’s in their work as much as possible.

Take a look at our AI-powered PIRP note.

A draft is created for you, allowing you to save time by simply reviewing and editing, rather than writing an entire session note from scratch.

Concluding thoughts

Now that you know all about the PIRP note, you can use it when and if you come across some of the cases and situations described above.

As we explored, the PIRP note is the perfect choice for providing a good balance of internal and external landscapes, and allows you to be treatment and intervention focused, while still spending time on the client’s internal state and assessment.

Of course, each clinician is free to use whatever progress note style they prefer. However, it’s our experience that clinicians are incredibly busy out of the gate, and some aren’t taught documentation at university! Hopefully, you’ll now have an idea of what the PIRP note is all about, and when appropriate add it to your admin routine and therapeutic care.

Happy writing!

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