GIRP notes for therapists: format, examples and template

GIRP (Goal, Intervention, Response, Plan) is a progress note format that opens each note with the treatment-plan goal the session worked on, then records what the clinician did, how the client responded, and what comes next.

GIRP structure

  • GGoal

    The treatment-plan goal and objective(s) this session addressed, in the plan's wording, plus the client's own focus for the session. Starting here ties every note back to the plan.

  • IIntervention

    What the clinician did toward the goal: named techniques (cognitive restructuring, exposure, motivational interviewing, skills practice, psychoeducation, safety planning) and any scales administered and reviewed.

  • RResponse

    How the client responded: engagement, affect, insight, skill use, and progress toward the objective, with the score change from baseline when a scale was given.

  • PPlan

    Next steps: next-session focus, between-session tasks, frequency, referrals, scales to re-administer, safety planning, and the next treatment-plan review.

Example: generalized anxiety, individual CBT

  • Fictional example

    Date: 2026-10-20 Time: 10:00–10:45 (45 min, 90834) Diagnosis: F41.1 Generalized Anxiety Disorder Client: M.K., age 36, session #5 of 12 G: Goal Treatment-plan Goal 1: "Stop worry from running my evenings." Objective 1a: GAD-7 below 10 by 2026-12-15 (baseline 15). Objective 1b: Use a scheduled 15-minute worry period on at least 5 evenings a week. Session focus (client's words): "I keep checking work email at night." I: Intervention GAD-7 administered and reviewed with client: 11 (15 at intake; 13 at session 3). Reviewed worry-period log. Cognitive restructuring on the thought "if I don't answer tonight, they'll think I'm not coping." Behavioural experiment designed: no work email after 19:00 on three weekday evenings. R: Response Client used the worry period on 4 of 7 evenings (up from 2). Generated a balanced alternative thought with one prompt; rated belief in the original thought down from 70% to 40%. Some anxiety about the experiment, but agreed to it and named a colleague who can cover urgent messages. Moving toward Objective 1a: GAD-7 down 4 points from baseline, still in the moderate band. P: Plan Continue weekly CBT. Client to run the email experiment on three evenings and log anxiety before and after. Keep the worry period nightly. Re-administer GAD-7 at session 7. Treatment-plan review at session 8. CPT: 90834 + 96127×1 (GAD-7)

    The Goal section quotes the plan's objective (GAD-7 below 10), so the Response section can state progress against it in numbers. The note bills 90834 plus 96127 for the GAD-7, scored and reviewed in session.

Example: PTSD, graded exposure

  • Fictional example

    Date: 2026-10-22 Time: 13:00–13:55 (55 min, 90837) Diagnosis: F43.10 Post-Traumatic Stress Disorder, Unspecified Client: D.R., age 44, session #7 of 16 G: Goal Treatment-plan Goal 2: "Drive to work again without pulling over." Objective 2a: Complete hierarchy steps 1-6 (driving) by 2027-01-31. Objective 2b: PCL-5 at least 10 points below baseline (baseline 52) by session 12. I: Intervention PCL-5 administered and reviewed: 44 (52 at intake). Reviewed between-session exposure log. In-session imaginal rehearsal of hierarchy step 4 (merging onto the highway) with grounding skills; processed the thought "I'll lose control of the car." Planned in-vivo practice of step 4 with a support person. R: Response Client completed step 3 (residential streets, alone) four times this week; distress ratings fell from 70 to 35 across trials. During rehearsal, distress peaked at 75 and settled to 40 by the end. Client stated, "It went down, which I didn't think it would." Toward Objective 2b: PCL-5 down 8 points from baseline. Denies SI. P: Plan Continue weekly sessions. Step 4 in vivo twice with a support person, logging distress at start, peak and end. Re-administer PCL-5 at session 9. Review the hierarchy at session 8. CPT: 90837 + 96127×1 (PCL-5)

Copy-ready template

  • Date
    —
    Time
    —
    Minutes
    —
    Diagnosis
    —
    Client
    —
    Session
    —
    CPT
    —

    G Goal

    Treatment-plan goal and objective(s) addressed this session, in the plan's wording. Client's own goal for the session if different.

    I Intervention

    Specific therapeutic interventions used toward the goal. Techniques (CBT, DBT, MI, psychoeducation, exposure, safety planning). Scales administered: PHQ-9 ___, GAD-7 ___ (whichever administered).

    R Response

    Client response to each intervention: engagement, affect, insight, skill use. Progress toward the objective, with score change from baseline.

    P Plan

    Next-session focus, between-session tasks, frequency, referrals, scales to re-administer, safety planning, plan review date.

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When to use GIRP

  • GIRP suits care where each session is organized around a written treatment plan and the record needs to show progress toward its goals:

    • Goal-structured treatment. Programs that set explicit goals and objectives at intake and review them on a schedule.
    • Payer documentation. Coverage policies such as LCD L33252 (a Medicare contractor's) ask that psychotherapy notes show the interventions and progress toward measurable goals; GIRP puts the goal at the top of every note.
    • Measurement-based care. When an objective is a scale target (for example, a PHQ-9 of 9 or less), the Response section records each score against it, so the trend is visible note by note.

    GIRP and BIRP share the Intervention, Response and Plan sections; GIRP replaces Behaviour with the session's goal from the treatment plan. Observations that BIRP records under Behaviour, including a brief mental status exam, go into Response in GIRP.

Measurement-based care

…starts with what we measure, and how long.

Frequently asked questions

  • What does GIRP stand for in therapy notes?

    GIRP stands for Goal, Intervention, Response and Plan. Each note opens with the treatment-plan goal the session addressed, then records the clinician's interventions, the client's response, and the plan for next steps.

  • What is the difference between GIRP and BIRP notes?

    Both share Intervention, Response and Plan. BIRP opens with the client's observed behaviour; GIRP opens with the treatment-plan goal the session worked on. Choose GIRP when the record needs to show progress against written goals in every note.

  • What goes in the Goal section of a GIRP note?

    The treatment-plan goal and objective addressed in this session, in the plan's wording, and the client's own focus for the session if it differs. Keep it short: the detail belongs in Intervention and Response.

  • Where do scale scores go in a GIRP note?

    Record the administration and score in Intervention, and the change from baseline toward the objective in Response. If you bill CPT 96127, document the scale name, the score and how it informed the session.

Sources & Citations

    1. 1.Centers for Medicare & Medicaid Services (Medicare contractor LCD). Local Coverage Determination L33252: Psychiatric Codes. Psychotherapy documentation: goal-oriented outcomes, interventions and treatment-plan updates.
    2. 2.U.S. Department of Health & Human Services. 45 CFR 164.501, definition of psychotherapy notes (what stays in the record).
    1. 3.American Psychological Association. Record keeping guidelines. Am Psychol. 2007;62(9):993-1004. PMID 18085845.
    2. 4.American Medical Association. Current Procedural Terminology (CPT) 2026, code 96127 documentation requirements.