In Brief
No one wants to bog down their progress notes with unnecessary information or (arguably worse) have incomplete or non-compliant documentation. That’s where note taking structures can be a helpful tool. While there are over a dozen types of these session note formats, if you’re looking for your documentation to be more goal-oriented, GIRP might be a great fit. Organized into four areas – client-centered Goals, therapist Interventions, your client’s observable Response, and setting an actionable Plan for next steps– GIRP notes can help you stay focused on your client’s objectives and progress, while providing a way to write a clear, concise overview of each session.
With that said, it can be helpful to see how the GIRP format is applied to a few different example scenarios to get a better understanding of how they work and the best level of detail. If you’re also looking for a more in-depth guide to GIRP notes, we’ve got that for you too.
What Are GIRP Notes?
As mentioned above, GIRP notes are a structured method for documenting therapy sessions, focusing on four key components: Goals, Intervention, Response, and Plan. Along with other note styles, the main purpose of GIRP notes is to ensure continuity of care, track patient outcomes, and provide a clear, concise record of each session. What makes GIRP notes distinct is that they are goal-oriented in their approach, emphasizing the client's objectives and progress as they relate to therapist interventions.
Let’s take a look at the four areas of a GIRP note:
- Goals: This section lays the foundation of the GIRP approach, as it focuses on the client's objectives for therapy (both short-term and long-term) that they aim to achieve. These goals should be client-centric, align with the overall treatment plan, and directly address your client’s presenting concerns. When setting goals, use the SMART criteria so that they’re clear and measurable, which better makes them measurable for tracking progress over time.
- Intervention: Next, you’ll document the therapeutic techniques and strategies you used during the session. These interventions should be directly linked to the client’s goals to demonstrate a clear treatment approach and explain the rationale informing your approach. Be sure to be specific about the actions, questions, and guidance that you provided to your client.
- Response: Here’s where you’ll capture your client’s reactions, insights, and progress in response to the interventions you used, paying close attention to any resistance, challenges, or breakthroughs. Be sure to document both verbal and non-verbal responses to gain a comprehensive understanding of your client’s experience. Noting your client’s response also lets you assess the effectiveness of the interventions you used – aim to identify areas that may require further exploration or adjustment in future sessions.
- Plan: In this final section, you’ll outline the next steps and future direction of treatment, including both short-term and long-term goals, homework assignments, and any adjustments to be made based on your client’s’ progress and needs. This is also where you’ll note scheduling for any follow-ups or referrals needed.
Tips for Writing Effective GIRP Notes
- Clarify and Align with Client Goals: Always ensure the client's goals are clearly stated to reflect the client's desired outcome. It’s important to clarify those objectives to better make them measurable, trackable, and achievable.
- Be Specific and Concrete: Particularly within the Intervention and Response sections, describe specific therapeutic techniques employed and the client's direct response to those interventions. Try to avoid vague terms like "seemed better" or "talked about feelings"—instead, document observable behaviors or statements that reflect the client’s progress or challenges in relation to their goals.
- Document Progress and Setbacks: Aim to detail not only any progress made but also setbacks or challenges the client faced. Be objective in describing both positive and negative reactions, as this will help inform future interventions and adjustments to the treatment plan.
- Ensure a Clear, Actionable Plan: The best goals are ones that can be tracked and achieved, and a plan is necessary to get there. Be sure to outline concrete, actionable steps for the next session or treatment phase. Specify the interventions to be used in the future and how they will help the client move closer to their goals.
GIRP Note Examples
It can help to see the GIRP format in action. With some examples, we’ll explore several variations across different therapy types, and client concerns, so you can better get a feel for how they function and sound:
Example 1: Anxiety Management
- G: Client’s goal is to reduce anxiety and improve sleep by utilizing coping strategies for work-related stress.
- I: Therapist provided psychoeducation on mindfulness techniques and guided the client through a deep breathing exercise to manage anxiety symptoms. Therapist also explored strategies for incorporating these techniques into the client’s daily routine, emphasizing the importance of consistency in practice.
- R: Client appeared engaged and focused, practicing the techniques during the session and expressing interest in using them daily. Client reported ongoing difficulty sleeping and feelings of being overwhelmed by work stress, indicating functional impairments in daily life and contributing to heightened anxiety levels. Client expressed a desire to implement the learned strategies to improve their situation. No suicidal or homicidal ideation was suspected or disclosed.
- P: Client will continue practicing grounding techniques regularly and integrate mindfulness exercises into their daily routine. Therapist will discuss potential adjustments to work-life balance or time management strategies in the next session. Follow up in one week to review client’s progress.
Example 2: Depression Symptoms
- G: Client’s goal is to increase engagement in pleasurable activities and improve task completion at work.
- I: Therapist introduced behavioral activation strategies, encouraging the client to schedule enjoyable activities and use structured problem-solving techniques to enhance task completion at work. Therapist guided the client in identifying specific activities they used to enjoy and discussed ways to reintroduce these into their routine.
- R: Client reported feeling somewhat motivated but continued to struggle with initiating tasks. Client reported they will try to enhance task completion by breaking their tasks into smaller parts, but admitted that this process is extremely draining and does not feel like they can engage with this process. Client continues to have ongoing struggles with motivation. No risks of self harm or harm to others were presented at this session.
- P: Introduce a weekly activity schedule to increase engagement in positive activities. Client will continue using problem-solving strategies for work tasks. Follow up in the next session to assess progress and further refine interventions.
Example 3: Grief and Loss
- G: Client's goal is to process grief and engage in self-care activities despite ongoing sadness.
- I: Therapist engaged the client in grief-processing exercises, including exploring memories of the deceased and encouraging emotional expression. Therapist also encouraged the client to continue to sort through personal belongings as part of their grief processing, highlighting the value of this activity could have on the client, especially on items that are deeply sentimental.
- R: Client expressed sadness but participated openly in the grief work, reporting progress in sorting through their loved one's belongings for 10 minutes over the weekend. Client continues to be tearful when discussing their grief, but is displaying better use of coping skills in order to continue with their daily activities.
- P: Continue utilizing grief processing techniques, including journaling and exploring support group options. Schedule a follow-up session in two weeks to evaluate ongoing grief work and adjust treatment strategies as necessary.
Example 4: Self-Esteem Issues
- G: Client’s goal is to improve self-esteem by challenging negative self-talk and increasing self-compassion.
- I: Therapist utilized cognitive reframing and cognitive restructuring techniques to challenge the client’s negative self-talk, specifically focusing on cognitive distortions related to work performance. Therapist provided examples and guided the client in identifying negative thoughts and reframing them into more positive perspectives, for example, client stated that they felt they failed at their tasks a lot this week, and through positive reframe, client was able to see that they tried their best this week, as evidenced by working longer hours in order to perfect their deliverable.
- R: Client appeared visibly disheartened when discussing self-worth but showed openness to exploring reframing techniques. Although the client was able to identify several cognitive distortions, they did not report significant changes in overall self-esteem, indicating a need for continued focus on these areas.
- P: Continue working on cognitive restructuring exercises, focusing on challenging persistent negative thoughts. Schedule weekly check-ins to assess progress and adjust strategies as needed.
Example 5: ADHD Management
- G: Client’s goal is to improve focus and organization, specifically in school-related tasks and homework completion.
- I: Therapist used a Brief Solutions-Focused Therapy approach, encouraging the client to identify positive school experiences to foster motivation. Additionally, the therapist assisted the client in problem-solving organizational strategies to enhance focus and manage homework efficiently.
- R: Client was actively engaged and motivated to improve organizational skills but reported difficulty with task completion at school and minimal progress toward completing homework before 9:00 PM. Client was distracted during session and had to be redirected several times, however, client was easily redirected, and was able to focus for slightly longer towards the end of session. This ongoing challenge indicates a need for enhanced organizational strategies to address functional impairments in academic performance.
- P: Collaborate on a personalized organizational system that incorporates checklists and timers. Follow up in the next session to review the client’s progress with homework completion and organizational strategies.
Integrating GIRP Notes into your Practice
There are a lot of benefits when it comes to adding the GIRP note format to your therapist “toolbox.” When aiming to provide the best client-centered care possible, knowing how to use a goal-oriented approach can be rewarding for you and your client to track and document meaningful progress during your sessions together. To make it more seamless to maintain a consistent format for your notes, consider making a template so you can be uniform in how you track your client’s progress. A unique note has to be written for every session, the template can help you ensure that you’ve accounted for each of the components in every note.
In addition to a clear format, realizing the goal-oriented nature of the GIRP format can also be helpful in targeting future interventions to explore, which can and ultimately improve outcomes.
Adopting GIRP notes in your practice can transform the way you deliver care. Not only will it enhance your professional growth and skills, by involving clients in goal-setting and tracking progress, this format can foster a collaborative, client-centered approach that may strengthen your therapeutic relationship. The role of effective, goal-centered documentation in therapy cannot be overstated – it is an essential tool for delivering high-quality, client-centered care.