What does BIRP stand for?

BIRP stands for Behaviour, Intervention, Response, Plan. It is a clinical note format used by therapists to document sessions. The Behaviour section covers what the client presented with, Intervention covers what the therapist did, Response covers how the client responded to interventions, and Plan covers what happens next.

When should I use BIRP notes?

BIRP notes are particularly well-suited to solution-focused, CBT, and behavioural approaches where the focus is on interventions and measurable outcomes. They are also widely used in NHS Talking Therapies and structured therapy programmes where tracking response to intervention is important. They are less commonly used in open-ended psychodynamic or person-centred therapy.

What is the difference between BIRP and SOAP notes?

SOAP notes (Subjective, Objective, Assessment, Plan) are more focused on the therapist's clinical assessment and formulation. BIRP notes (Behaviour, Intervention, Response, Plan) are more focused on what was done in the session and how the client responded. BIRP is more action-oriented; SOAP is more assessment-oriented.

Can AI write BIRP notes for UK therapists?

Yes. NoteSono generates BIRP notes from a brief voice summary after the session. You describe what happened in the session, what interventions you used, and how the client responded, and NoteSono drafts a structured BIRP note for you to review. BIRP is on the free plan. NoteSono stores notes in the EU and is ICO registered.

Are BIRP notes GDPR compliant?

BIRP notes are a clinical note format — their GDPR compliance depends on how they are stored and processed, not the format itself. Therapy notes should be stored securely, in the UK or EU or with a valid transfer safeguard, covered by a documented retention policy, and included in your privacy notice. NoteSono stores notes in the EU; some AI processing uses providers outside the UK and EU under data processing terms that exclude training on your data. It is ICO registered.

BIRP Notes for Therapists: Complete Guide with Examples (UK)

BIRP notes are a structured clinical note format that focuses on what happened in a therapy session — particularly the interventions used and how the client responded. They are widely used in NHS Talking Therapies, CBT and structured therapy programmes across the UK.

What are BIRP notes?

BIRP stands for Behaviour, Intervention, Response, Plan. Unlike SOAP or DAP notes, BIRP is focused on the therapeutic process rather than the therapist's formulation. It documents what the client presented with, what the therapist did, how the client responded, and what happens next.

The four sections of a BIRP note

B — Behaviour

The Behaviour section documents the client's presentation at the start of the session — both what they reported and what you observed. This includes mood, affect, presenting concerns, risk factors, and any significant events since the last session.

I — Intervention

The Intervention section documents what you did as the therapist. This is the most distinctive part of BIRP notes — it requires you to specifically identify the therapeutic interventions used in the session. Examples include: psychoeducation, cognitive restructuring, behavioural activation, exposure exercises, relaxation techniques, Socratic questioning, EMDR processing, schema work.

R — Response

The Response section documents how the client responded to your interventions. This is clinically important because it tracks whether the interventions are working and informs your plan for future sessions. Did the client engage? Did they find the intervention useful? What was their emotional response?

P — Plan

The Plan section documents next steps: what you will do in the next session, any homework or between-session tasks, referrals, and risk management actions.

BIRP note example

BIRP Note Example — CBT, session 5

B: Client presented as anxious, reporting increased worry over the past week related to work performance. PHQ-9 score 11 (moderate depression, down from 14 at intake). Affect anxious but engaged. No suicidal ideation. Client identified several avoidance behaviours at work as the main concern this week.

I: Cognitive restructuring was used to examine the evidence for and against the client's belief that he would be dismissed for underperformance. Thought record completed collaboratively. Introduced the concept of behavioural activation and discussed the connection between avoidance and maintaining anxiety. Explored feared consequences of reducing avoidance behaviours.

R: Client engaged well with the thought record and was able to identify cognitive distortions (catastrophising, mind-reading) independently by the end of the session. Initially resistant to the idea of reducing avoidance, but was able to identify one small behavioural experiment he was willing to try before the next session. Mood appeared to lift slightly during the session.

P: Client agreed to send one work email he has been avoiding before the next session (behavioural experiment). Review thought record and discuss outcome of behavioural experiment at session 6. Continue cognitive restructuring. PHQ-9 to be completed at next session.

When to use BIRP notes

BIRP notes work particularly well for:

CBT and cognitive-behavioural approaches
Structured therapy programmes with defined interventions
NHS Talking Therapies and stepped care settings
Goal-focused therapies where tracking progress matters
Settings where audit or outcome measurement is required

BIRP notes are less commonly used in open-ended psychodynamic, person-centred, or humanistic therapy, where the focus is on the therapeutic relationship and the therapist's formulation rather than specific interventions.

Generating BIRP notes with AI

NoteSono drafts BIRP notes from a short post-session voice summary. You describe what the client brought, what interventions you used, how they responded, and your plan — and NoteSono drafts a structured BIRP note for you to review.

Draft BIRP notes from a short summary

Speak a brief post-session summary. NoteSono drafts a BIRP note. BIRP is on the free plan. Free plan available, no card needed.

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