Behavioral health therapists frequently need to take notes both during and after a session. Tracking behaviors big and small play an important role in helping improve a patient’s treatment trajectory and meet therapeutic outcomes.
In many ways, accurate notes play an important purpose. First and foremost they help catch behaviors on various scales. This also serves as an initial platform for tracking progress in efficient ways. Though there are different types of notes that an ABA therapist might choose to use based on the patient and the treatment goals. Three of the most commonly used types are PIRP, GIRP, and BIRP notes. While they share some similar acronyms they are different and can be used in different ways.
What Do The Acronyms Mean?
Each letter of the note-taking system stands for a different aspect of the session. The major emphasis is on either an identified problem, an established goal, or a behavior that needs modification.
PIRP
Problem Intervention, Response, Plan
GIRP
Goal, Intervention, Response, Plan
BIRP
Behavior, Intervention, Response, Plan
To be effective, we need to take a closer look at each and the finer details of how to use them for a specific patient.
Why Do Specific Note Formats Matter?
The most notable differences between PIRP, BIRP, and GIRP notes and which one to choose is going to be based on the emphasis for the session at hand. Different patients who are going through customized treatment plans might benefit from one note-taking format over another in both the long and short term.
If a session needs to focus on identifying a problem PIRP notes are more appropriate. If the session needs to better outline a goal or help track the progress of a goal then GRIP notes are typically the more effective choice. If a behavior needs to be worked on or more tracking data needs to be collected as the patient reaches an important milestone, then BIRP notes might be the best format.
A Closer Look How To Use PIRP Notes
As the acronym implies PRIP notes focus on active problems that need to be identified and obstacles that might be getting in the way of a patient being able to modify their behavior in certain environments.
Problem
This could be a specific condition or complaint that presents itself early or in the middle of a session. It might also be started from a note taken at the end of a previous session where someone wanted to talk about something “Next time.” In some of these cases, the “Problem” may require intervention.
The “Problem” portion of a PIRP note needs to include an accurate, objective assessment of the problem’s current level. If the problem happens to be symptoms of depression the therapist will need to record the frequency and severity of those symptoms. This might also include things that are contributing to the depression symptoms such as recurring struggles with substance abuse.
Intervention
This note section will describe the treatment plan the therapist advocates and may include pertinent recommendations for coping strategies to reduce obstacles.
Response
This section of the PIRP notes indicates the patient’s response to the intervention. It is important to note positive receptivity or negative opposition. It is often best to include what the patient said verbatim.
Plan
This portion of the notes, is where the therapist records the next steps for ongoing treatment. It might include recommendations for what the patient could do before the next session, referrals to another specialist, medications prescribed, and so forth.
A Closer Look How To Use GIRP Notes
Whether they are short-term or long-term goals, GIRP notes always focus on the patient’s progression toward an established goal rather than trying to solve a problem. These are formatted to be helpful for situations where the patient and therapist actively define or have defined a clear goal together. This also helps track the patient’s progress.
Goal
The opening section of GIRP notes needs to include a description of the patient’s current objective, regardless of whether it is a long or short-term goal. They frequently note the previous assessment or ongoing treatment strategy.
Intervention
This section serves to describe the method used to propel the patient toward their goal. This typically includes details about approaches the clinician took and the reasoning behind them.
Response
In this section, the therapist includes details about the patient’s progress toward reaching the predefined objective. This should include the patient’s overall attitude and behavior such as feeling guarded about past struggles or enthusiastic about their recent progress.
Plan
This section of the GIRP notes includes the plan the therapist advocates for the next step or two in the behavior modification process. This might also include notes about possible referrals, or topics to discuss at the next session.
A Closer Look How To Use BIRP Notes
BIRP notes are best used to describe a session’s general theme as well as the patient’s emotional state or attitude. This places greater emphasis on observations and the patient’s self-reported thoughts. As such BIRP notes are more common with new patients as they help the therapist both get to know them as well as identifying the behaviors that need to be modified.
Behavior
This important section of the BIRP notes includes the therapist’s direct observations of a patient’s behavior as presenting the problem. This section typically includes the patient’s self-reported thoughts and feelings. This might also include signs and symptoms of other mental health conditions that might later come to influence the treatment process.
Intervention
With BIRP notes the intervention sections acts as more of a summary of the interaction and conversation with the patient as well as the therapist’s course of action. This might also include asking the patient to identify any links between certain stimulus and their own behavior.
Response
The response section of BRIP notes usually notes the patient’s response or attitude toward the recommended intervention. Since the therapist is often dealing with a new patient it is best to record direct quotes from the patient.
Plan
This is a basic outline of the plan or future steps toward positive behavior modification. It might also include identifying specific concerns or goals, consulting with other professionals, and the frequency of scheduling future sessions.
