Progress note formats compared: SOAP, DAP, BIRP, GIRP, PIRP, SIRP and PIE
Every common behavioral health progress note format, what each section is for, which settings favour which format, and a worked example of the same session written seven ways.
The short answer
SOAP, DAP, BIRP, GIRP, PIRP, SIRP and PIE are structured progress note formats used in behavioral health. They differ in how they organise the same information: what the client reported, what the clinician observed and did, how the client responded, and what happens next. No format is more compliant than another. What matters is that the chosen structure captures medical necessity and links the session to the treatment plan.
Key takeaways
- No payer requires a specific format. They require specific content.
- Problem-led formats (PIRP, PIE) make medical necessity easiest to see.
- Goal-led formats (GIRP) make the golden thread easiest to prove.
- Switching format will not fix a documentation problem. It only moves it.
Clinicians change note formats the way people change diets: hopefully, repeatedly, and usually in response to a problem the format was never causing. Before choosing, it helps to know what each structure actually optimises for.
The formats at a glance
| Format | Sections | Optimises for | Common settings |
|---|---|---|---|
| SOAP | Subjective, Objective, Assessment, Plan | Medical interoperability | Integrated care, prescribers, hospital systems |
| DAP | Data, Assessment, Plan | Speed | Outpatient therapy, high caseloads |
| BIRP | Behavior, Intervention, Response, Plan | Showing what the clinician did | Community mental health, case management |
| GIRP | Goal, Intervention, Response, Plan | Golden thread continuity | Payer-sensitive and audited environments |
| PIRP | Problem, Intervention, Response, Plan | Medical necessity | Medicaid and utilization-reviewed care |
| SIRP | Situation, Intervention, Response, Plan | Context-heavy encounters | Crisis work, case management |
| PIE | Problem, Intervention, Evaluation | Brevity | Nursing, inpatient, brief contacts |
What each section is really asking
The opening section
Every format opens by establishing why this session happened. SOAP asks what the client said. DAP asks what you know. BIRP asks what you saw. GIRP asks what you are working toward. PIRP and PIE ask what is wrong. That opening choice determines how obvious your medical necessity will be to a reviewer, which is why problem-led and goal-led formats fare better under audit.
The intervention section
This is where most notes lose value. 'Provided supportive therapy' names a category, not an act. A defensible intervention line names the modality, the specific technique, and the target.
Used CBT to address anxiety.
Delivered cognitive restructuring targeting catastrophic predictions about workplace evaluation; guided client through evidence-for and evidence-against, then assigned a thought record for daily completion.
The response section
Response is the section reviewers use to judge whether treatment is working, and the section clinicians most often skip. It should record what the client did with the intervention, in observable terms, ideally with a number attached.
The plan section
Plan is not 'continue weekly.' It is frequency, the clinical reason for that frequency, homework or between-session tasks, and what will be addressed next. Frequency without rationale is the most frequently cited weakness in continued-stay reviews.
The same session, seven ways
A 50-minute individual session. Adult client with generalised anxiety, working on workplace avoidance. Client reports two missed shifts, practises cognitive restructuring, distress drops from 7 to 4.
- SOAP: Subjective carries the client's report of missed shifts and sleep; Objective carries the abbreviated MSE and the in-session distress ratings; Assessment carries the clinical interpretation and necessity; Plan carries frequency and homework.
- DAP: Data merges the subjective report and observation; Assessment and Plan behave as in SOAP. Fastest to write, weakest at separating report from observation.
- BIRP: Behavior opens with presentation and report; Intervention names the restructuring; Response captures the 7 to 4 shift; Plan closes.
- GIRP: Goal opens by naming Objective 2 from the treatment plan, which makes the golden thread explicit in the first line.
- PIRP: Problem opens with the current impairment, which makes medical necessity explicit in the first line.
- SIRP: Situation opens with context, useful when the encounter was driven by an external event rather than a plan objective.
- PIE: Problem, Intervention, Evaluation. Compresses response and plan into evaluation. Efficient, but easiest to under-document.
Both formats force the note to open with the element a reviewer is looking for, the goal or the problem. That single structural choice does more for audit performance than any amount of extra prose later in the note.
What no format will fix
A format is a container. It cannot supply content that was never written. If your notes lack functional impairment, quantified response, or a link to the treatment plan, changing from SOAP to BIRP will produce the same gaps in a different order.
The useful test is not which format is best, but whether a stranger reading your note could answer three questions: what is wrong with this client right now, what did the clinician do about it, and how do we know whether it worked.
Frequently asked
SOAP separates the client's report (Subjective) from clinical observation (Objective). DAP merges both into a single Data section. DAP is faster to write; SOAP maps more cleanly onto medical records used by prescribers and integrated care teams.
Continue reading
GuideThe golden thread in behavioral health documentation
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GuideHow to document medical necessity in behavioral health
The four elements payers look for when testing medical necessity in behavioral health, the language that satisfies them, and the phrases that quietly undermine an otherwise strong note.
ReferenceMental status exam: domains, descriptors, and documentation
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