A PIRP note is a behavioral health note that can be used by clinicians to record individual progress during a therapeutic session. PIRP stands for Problem, Intervention, Response, and Plan. PIRP notes are similar to other notes (e.g., DAP and GIRP notes), except they focus on a particular problem rather than broader goals or client behavior. Here is everything you need to know about PIRP notes.
The first section of a PIRP note is what makes it distinct from a GIRP or BIRP note. The focus is on a particular problem. That being said, the PIRP note should ideally be used when a client (or therapist) focuses on a specific issue during the session.
The problem section should provide the answer to the following questions:
- What is the presenting problem?
- What symptoms is the client reporting?
- What prevents the problem from being resolved?
- What is the client's diagnosis, if any?
Tips for writing the Problem section of a PIRP note:
- Use a client’s own words to describe the problem.
- The problem should be reflected in the treatment plan. If it isn’t, the treatment plan can be adjusted.
- Use your professional judgment to assess the problem as well as the client’s subjective experience.
Three PIRP notes examples of possible problems:
- Jane reports that she has been cutting her arm because she feels “empty”.
- Sebastian says he is afraid to leave his house because he is worried he will leave his door unlocked.
- Dana appears to be exhibiting symptoms of alcoholism.
The intervention section in a PIRP note is directly linked to the problem. It is what is being done in session to address the client’s issue.
The intervention section should provide the answer to the following questions:
- What interventions did the therapist use?
- How did the therapist help the client work towards addressing their issue?
- Did the therapist teach the client any specific skills to deal with their problem?
Tips for writing the intervention section of a PIRP note:
- A direct link between the client’s problem and the clinician’s intervention should be displayed.
- Action words (e.g., discussed, performed) are used to exhibit therapist interventions.
- Give the client something tangible they can take from the session to address their problem.
Three PIRP note examples of possible interventions:
- A safety plan was created with Jane to prevent self-harm.
- This therapist explained exposure and response prevention (ERP) to Sebastian as a treatment for OCD behavior.
- The therapist explored with Dana the possibility she has a drinking problem.
The response section details the client’s response to the intervention. These responses can reflect the actual reaction in session, as well as their follow-through outside of treatment. This section is made up of both objective client behavior and subjective therapist interpretation.
The response section should provide the answer to the following questions:
- How did the client react to the therapist’s interventions?
- Does the client appear motivated to adopt the intervention?
- Is there something preventing the client from performing the intervention?
Tips for writing the response section of a PIRP note:
- Include both positive and negative reactions to interventions.
- What challenges is the client reporting in following through with treatment?
- Use direct client quotes.
Three PIRP note examples of possible Responses:
- Jane participated in the creation of her safety plan but expressed doubt as to whether anything but cutting could help with her feelings of emptiness.
- Sebastian appeared motivated to try ERP techniques and asked for homework to practice.
- Dana initially became defensive (“I am not an alcoholic”), but said she would ask her husband about his thoughts regarding her drinking.
The plan section details what is next and the direction you want to go. The plan makes clear where the treatment is heading.
The plan section should provide the answer to the following questions:
- When is the date and time of the next session?
- Was the client assigned homework?
- What interventions may be attempted next session to address the client’s problem?
Tips for writing the plan section of a PIRP note:
- Note any referrals to other professionals for related treatment.
- Adjust the overall treatment plan if the problem is not reflected in the treatment goals.
- Homework should directly address the resolution of the client’s problem.
Three PIRP note examples of possible Plans:
- This therapist will follow up with Jane’s psychiatrist for medication management regarding her depressive feelings and self-harm.
- Sebastian was given the first chapter of an ERP workbook as homework.
- The next therapy session with Dana is Tuesday at 6 pm.
PIRP Note example
Here is an example of a PIRP note for Sebastian, who appears to be suffering from OCD.
Client: Sebastian Doe
Sebastian states he has difficulty leaving his house because he is worried he will leave his front door unlocked. It started three months ago when he found he had left his front door unlocked all day while he was at work. Now, he checks his locks “15 times or more” before he leaves his house and often has to go back home to check again throughout the day. It is disrupting his work and social life. His symptoms are consistent with obsessive-compulsive disorder (OCD).
This therapist discussed with Sebastian how his symptoms appear to be related to OCD. Exposure and response prevention was recommended as an appropriate treatment. Sebastian was given the name of a workbook that he could use at home to complement his work in therapy. The general process of ERP was explained and illustrated in the session.
Sebastian seemed slightly alarmed at hearing he might have OCD but his anxiety appeared to ease as it was further explained. He said he understood the concepts behind ERP and was motivated to engage in treatment. He asked about what he could do at home to further his progress. He said he would buy the recommended workbook and complete the first chapter.
This therapist will meet with Sebastian again next Monday at 7 p.m. The first chapter in the workbook will be discussed and the second chapter will be assigned for homework. A related exposure exercise will also be conducted in session. Medication referral will also be evaluated as the severity of his problem is further assessed.
PIRP notes provide a quick and clear template for addressing client problems in a mental health treatment setting. The focus on a specific problem differentiates it from other forms of progress notes.
Electronic Health Records (EHRs) hold the potential to boost the efficiency and accessibility of PIRP (Problem, Interventions, Response, and Plan) notes for private practice therapists.
The integration of an EHR, along with practice management software such as TheraPlatform, delivers a host of advantages:
Advantages of EHRs for PIRP Notes
- Tailored templates for effortless PIRP note creation: EHRs like TheraPlatform provide therapists with ready-made PIRP note templates, streamlining the note-writing process. These templates can be personalized to align with the unique needs of therapists' practices. Centralizing PIRP notes within EHRs enhances accessibility.
- Versatile note template builder: EHRs provide a template builder as a foundation for PIRP note documentation. These templates come equipped with essential fields, simplifying the completion of various sections of a PIRP note. Therapists can tailor templates to match their preferred documentation style. This user-friendly template builder saves time and offers customization flexibility.
- HIPAA-Compliant data storage: TheraPlatform places a strong emphasis on the secure storage of PIRP notes through robust encryption and security measures. Furthermore, they offer legally-binding Business Associate Agreements to ensure Protected Health Information (PHI) is safeguarded and in compliance with HIPAA regulations.
- Secure and convenient note sharing: There are various reasons to share PIRP notes, whether it's to fulfill insurance requirements, enhance transparency in mental health care or provide clients with insights into their progress. EHRs simplify secure and hassle-free access to PIRP notes, saving time compared to traditional paper-based methods.
- Integration with Wiley Treatment Planners: TheraPlatform seamlessly integrates with Wiley Treatment Planners, enabling therapists to promptly access evidence-based treatment objectives, interventions, homework assignments, along with diagnostic codes like ICD-10 and DSM-5. This integration streamlines treatment planning, enabling therapists to save valuable time.
- Copy previous PIRP notes: While the content of PIRP notes generally changes from one session to the next, certain information remains repetitive. EHRs enable therapists to duplicate pertinent notes and retrieve data from previous sessions. Homework assignments from earlier plans can also be carried forward, with the ability to edit notes as necessary.
- Signature requests are effortless: TheraPlatform's Pro and Pro Plus plans offer the convenience of requesting electronic signatures directly on notes. This feature is particularly valuable when working with pediatric clients where signatures from parents or legal guardians are required. Clients can effortlessly download and print these documents as needed.
- Efax integration: TheraPlatform, an all-in-one EHR, practice management, and teletherapy solution, offers efax integration. This eliminates the need to juggle multiple services, saving time and reducing costs by enabling seamless sending and receiving of documents like PIRP notes via efax directly within TheraPlatform. No more dealing with traditional fax machines!
By harnessing an EHR like TheraPlatform, therapists can enjoy an elevated quality and efficiency in their PIRP notes, streamline their workflows, ensure secure data storage, and have convenient access to records taking some of the frustration away from the administrative tasks associated with running a private practice.
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