What Are SOAP, DAP, and BIRP Notes?
SOAP, DAP, and BIRP are three structured progress note formats used by mental health professionals to document therapy sessions. Each format organizes clinical information into distinct sections, but they differ in how they categorize that information and what they emphasize.
SOAP (Subjective, Objective, Assessment, Plan) is the most widely used format across all healthcare disciplines. It separates the client's self-report from the clinician's observations before moving to clinical interpretation and treatment planning. See the full SOAP note template and examples for a deep dive into this format.
DAP (Data, Assessment, Plan) consolidates the client's report and the clinician's observations into a single Data section, followed by the clinician's assessment and plan. It is essentially a streamlined version of SOAP. The complete DAP note template guide covers the format section by section.
BIRP (Behavior, Intervention, Response, Plan) leads with observable behavior, then documents the specific interventions used, the client's response to those interventions, and the plan. It places the strongest emphasis on the intervention-response link. Our BIRP note template guide walks through each section with worked examples.
All three formats, when used correctly, satisfy the fundamental requirements of clinical documentation: they record what the client presented, what the clinician did, what the clinical picture looks like, and what happens next. The differences lie in organization and emphasis — and those differences matter depending on your clinical setting, payer requirements, and documentation goals.
When You Need It
This comparison guide is useful when:
- You are choosing a note format for a new private practice or group practice
- Your agency is evaluating whether to change its documentation format
- You are transitioning between clinical settings that use different formats
- You are training supervisees or interns on documentation and want to present options
- You want to understand why a particular format was chosen for your setting
Key Components: Side-by-Side Comparison
| Element | SOAP | DAP | BIRP |
|---|---|---|---|
| Sections | 4: Subjective, Objective, Assessment, Plan | 3: Data, Assessment, Plan | 4: Behavior, Intervention, Response, Plan |
| Client's self-report | Subjective section (standalone) | Combined in Data section | Part of Behavior section |
| Clinician's observations | Objective section (standalone) | Combined in Data section | Part of Behavior section |
| Interventions used | Embedded in Objective section | Embedded in Data section | Standalone Intervention section |
| Clinical interpretation | Assessment section | Assessment section | Implicit across Response section |
| Client's response to treatment | Embedded in Assessment | Embedded in Assessment | Standalone Response section |
| Treatment planning | Plan section | Plan section | Plan section |
| Emphasis | Separating client report from clinician observation | Efficiency and simplicity | Intervention-response linkage |
| Origin | Medical settings (Dr. Lawrence Weed, 1960s) | Adapted from SOAP for counseling | Community mental health settings |
| Best for | Medical model settings, multidisciplinary teams | Private practice, school counseling | Community mental health, substance use treatment |
Pros and Cons
SOAP Notes
- Pros: Universally recognized across healthcare disciplines; clear separation of subjective and objective data; familiar to physicians, psychiatrists, and insurance reviewers; strong legal defensibility due to its widespread use
- Cons: Can feel redundant for psychotherapy (the Objective section can be thin when no physical exam or lab work is involved); requires distinguishing between subjective and objective — a distinction that is sometimes unclear in therapy
DAP Notes
- Pros: Simpler three-section structure reduces redundancy; faster to write; eliminates the sometimes-artificial line between Subjective and Objective in therapy settings; effective for clinicians who find SOAP's four sections cumbersome
- Cons: Less universally recognized outside of behavioral health; the combined Data section can become a disorganized list if not written carefully; may not satisfy reviewers who expect clear separation of client report and clinician observation
BIRP Notes
- Pros: Dedicated Intervention section forces documentation of specific clinical techniques; Response section captures treatment effectiveness; strong format for demonstrating medical necessity and active treatment; well-suited for Medicaid and managed care documentation requirements
- Cons: Less intuitive for clinicians trained in the medical model; the Behavior section can overlap with the Response section if not carefully delineated; less familiar to providers outside behavioral health; no dedicated Assessment section for formal clinical interpretation
Setting Considerations
Private practice: DAP or SOAP are the most common choices. DAP is efficient and well-suited for solo practitioners managing their own documentation. SOAP is preferable if you frequently coordinate care with medical providers who expect the SOAP format.
Community mental health / county agencies: BIRP is the dominant format in many community mental health centers, especially those serving Medicaid populations. The intervention-response structure aligns well with utilization review requirements that demand evidence of active treatment.
Hospital / medical settings: SOAP is the standard. If you are embedded in a hospital, medical clinic, or integrated care setting, SOAP notes ensure your documentation is compatible with the broader medical record.
School-based settings: DAP is commonly used due to its simplicity. School counselors and school-based therapists often prefer DAP because it is quick to write between back-to-back sessions.
Substance use treatment: BIRP is frequently used in substance use treatment programs, particularly those funded through state or federal grants that require documentation of specific evidence-based interventions and client response.
Quick Decision Table
If you want the short answer, this table maps common situations to the format most likely to serve you well. It reflects common practice patterns, not mandates — always confirm your employer's and payers' actual requirements first.
| Your situation | Start with | Why |
|---|---|---|
| Employer or agency mandates a format | The mandated format | Compliance comes first; personal preference is irrelevant here |
| Solo private practice, mostly private pay | DAP | Fastest to write; no external reviewer expects a specific structure |
| Integrated care, hospital, or psychiatry-adjacent | SOAP | Matches the medical record; familiar to physicians and nurses |
| Community mental health / heavy Medicaid mix | BIRP | Intervention-response structure aligns with utilization review |
| Substance use / IOP / grant-funded program | BIRP | Demonstrates delivery of specific evidence-based interventions |
| School-based counseling, back-to-back sessions | DAP | Minimal structure, quick turnaround between students |
| Treatment-plan-driven agency with audited goals | GIRP | Ties every session note directly to a treatment plan objective |
| New clinician still building documentation habits | DAP or your site's format | Simplest structure to learn; switch later if your setting changes |
Beyond the Big Three: GIRP, PIRP, and Narrative Notes
SOAP, DAP, and BIRP dominate outpatient behavioral health, but you will encounter other structures, and it helps to recognize them:
GIRP (Goal, Intervention, Response, Plan) replaces BIRP's Behavior section with a Goal section that names the specific treatment plan objective addressed in the session. It is the strongest format for demonstrating the "golden thread" — the documented line from assessment to treatment plan to session note. If your agency audits notes for treatment plan alignment, GIRP makes that alignment explicit. See the GIRP note template for the full structure and examples.
PIRP (Problem, Intervention, Response, Plan) is structurally identical to GIRP except the opening section names the presenting problem addressed in the session rather than the treatment plan goal. It appears most often in settings that organize care around problem lists rather than goal hierarchies.
Narrative notes have no labeled sections — the clinician writes a prose account of the session. Narrative documentation is flexible but risky: without section headings, it is easy to omit required elements such as risk assessment, interventions, or the plan, and reviewers must hunt for the information they need. Most agencies and payers have moved away from purely narrative session notes for exactly this reason. If you currently write narrative notes, adopting any structured format — SOAP, DAP, or BIRP — will typically improve both compliance and writing speed.
The common thread across every format: regardless of the acronym, a defensible progress note documents what the client presented, what you did, how the client responded or how you interpret the clinical picture, the risk assessment, and what happens next. The format is the container; those elements are the content.
Switching Formats: How to Do It Cleanly
Clinicians change formats when they change jobs, when an agency updates its documentation policy, or when a practice adopts a new EHR whose note templates favor a different structure. A format transition is straightforward if you follow a few rules:
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Never retroactively reformat signed notes. Completed, signed records must stand as written. If a signed note needs correction, use a properly labeled addendum or late entry — see our guide to late entries and addendums for how to do this defensibly.
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Pick a clean transition date. Begin the new format on a defined date for all clients at once, rather than migrating client by client. A mixed-format chart across a date boundary is normal; a chart that alternates formats unpredictably invites reviewer questions.
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Map your old habits to the new sections before your first note. If you are moving from SOAP to BIRP, know in advance where your Assessment-style clinical reasoning will live (typically woven into Response, or as a brief clinical impression before the Plan). If you are moving from DAP to SOAP, practice separating what the client told you from what you observed.
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Write your first several new-format notes from a template, not from memory. Working from the blank SOAP, DAP, or BIRP template keeps sections in their intended lanes while the new structure becomes habitual.
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Confirm the new format captures every element your payers require. Format changes are a common moment for required elements to silently fall out of notes — most often risk assessment and medical necessity language. Audit your first week of new-format notes against your payer checklist.
Same Session, Three Formats
The following examples document the same therapy session — a 50-minute individual CBT session with a client experiencing generalized anxiety — in all three formats. The client, session details, and dates are entirely fictional and are provided for illustration only.
SOAP Format — GAD Session
Client: T.K. | Date: 03/12/2026 | Session: #5 (50 min) | Modality: Individual | CPT: 90834
S — Subjective: Client reports increased worry over the past week related to an upcoming performance review at work. States, "I've been catastrophizing about getting fired even though my manager said my work is good." Reports difficulty sleeping (waking at 3 AM with racing thoughts on 4 of 7 nights). Denies using any coping strategies between sessions. Reports taking escitalopram 10mg as prescribed with no side effects.
O — Objective: Client arrived on time, appropriately dressed. Affect was anxious — fidgeting with hands, rapid speech at session start. Eye contact was intermittent. GAD-7 score: 14 (moderate), unchanged from last session. Thought process was linear but marked by future-oriented worry themes. Cognitive restructuring was conducted in session targeting the catastrophic thought "I'm going to get fired." Clinician introduced worry time scheduling as a containment strategy. Client practiced the technique in session with guidance.
A — Assessment: GAD symptoms remain at moderate severity (GAD-7: 14) with no improvement from previous session. Client has not implemented between-session coping strategies, which likely contributes to stagnation. In-session cognitive restructuring was productive — client identified the probability overestimation distortion and generated the alternative thought "My manager has given me positive feedback; being fired is unlikely." However, client's pattern of not practicing skills between sessions is a barrier to progress. Current diagnosis: Generalized Anxiety Disorder (F41.1). Risk: Client denied suicidal and homicidal ideation; no acute safety concerns. Prognosis: Fair — contingent on between-session skill practice.
P — Plan:
- Continue weekly individual therapy (CBT for GAD)
- Client to implement worry time scheduling daily (15 minutes at 7 PM)
- Client to complete thought record for at least 2 worry episodes this week
- Discuss barriers to homework completion at the start of next session
- Continue escitalopram 10mg as prescribed
- Next session: 03/19/2026 at 11:00 AM
This is a sample for educational purposes only — not real patient data.
DAP Format — GAD Session (Same Session)
Client: T.K. | Date: 03/12/2026 | Session: #5 (50 min) | Modality: Individual | CPT: 90834
D — Data: Client reports increased worry related to an upcoming performance review, stating, "I've been catastrophizing about getting fired even though my manager said my work is good." Reports sleep disruption (waking at 3 AM with racing thoughts, 4 of 7 nights). Has not practiced coping strategies between sessions. Taking escitalopram 10mg as prescribed. Client presented with anxious affect — hand fidgeting, rapid speech at session start, intermittent eye contact. GAD-7 administered: score 14 (moderate), unchanged from session #4. Cognitive restructuring conducted targeting catastrophic thought "I'm going to get fired." Client identified the distortion (probability overestimation) and generated the alternative thought: "My manager has given me positive feedback; being fired is unlikely." Worry time scheduling introduced as a containment strategy and practiced in session.
A — Assessment: GAD symptoms remain at moderate severity with no measurable improvement (GAD-7: 14, stable). Client is responsive to in-session interventions — successfully completed cognitive restructuring with appropriate identification of the distortion. However, lack of between-session practice is a significant barrier to symptom reduction. Treatment plan remains appropriate but effectiveness is limited by homework non-adherence. Client denied SI/HI; no acute safety concerns. Diagnosis: Generalized Anxiety Disorder (F41.1). Prognosis: Fair, contingent on skill generalization outside of session.
P — Plan:
- Continue weekly CBT; address homework barriers at start of next session
- Implement worry time scheduling daily (15 min at 7 PM)
- Complete thought record for at least 2 worry episodes
- Continue escitalopram 10mg
- Next session: 03/19/2026 at 11:00 AM
This is a sample for educational purposes only — not real patient data.
BIRP Format — GAD Session (Same Session)
Client: T.K. | Date: 03/12/2026 | Session: #5 (50 min) | Modality: Individual | CPT: 90834
B — Behavior: Client presented with anxious affect including hand fidgeting, rapid speech, and intermittent eye contact. GAD-7 score: 14 (moderate), unchanged from previous session. Client reports increased worry about an upcoming work performance review, catastrophizing about being fired despite positive feedback from manager. Reports sleep disturbance — waking at 3 AM with racing thoughts on 4 of 7 nights. Client did not complete between-session coping practice as assigned. Medication adherence maintained (escitalopram 10mg).
I — Intervention: Administered GAD-7 to track symptom severity. Conducted cognitive restructuring using Socratic questioning to examine the catastrophic thought "I'm going to get fired," guiding the client to evaluate the evidence for and against this belief. Introduced worry time scheduling as a cognitive-behavioral containment strategy — provided psychoeducation on the rationale (delaying worry reduces its frequency and intensity over time) and guided the client through an in-session practice of the technique. Explored barriers to between-session homework completion, identifying perfectionism and avoidance as contributing factors.
R — Response: Client engaged actively in cognitive restructuring. Identified the probability overestimation distortion with minimal prompting and generated the alternative thought: "My manager has given me positive feedback; being fired is unlikely." Reported a reduction in anxiety from 7/10 to 4/10 after completing the exercise in session. During worry time practice, client initially had difficulty confining worry to the designated period but was able to redirect with clinician guidance. Client acknowledged that homework non-completion was related to "not wanting to do it wrong" and agreed this was a pattern worth addressing. Client denied suicidal and homicidal ideation; no safety concerns identified.
P — Plan:
- Continue weekly individual therapy (CBT for GAD)
- Client to implement worry time scheduling daily (15 min at 7 PM) — written instructions provided
- Complete thought record for at least 2 worry episodes; clinician clarified that imperfect thought records are clinically useful
- Address perfectionism as a barrier to skill practice in upcoming sessions
- Continue escitalopram 10mg as prescribed
- Next session: 03/19/2026 at 11:00 AM
This is a sample for educational purposes only — not real patient data.
How to Choose the Right Format Step by Step
Step 1: Check your employer or agency requirements. Many settings mandate a specific format. If your agency uses BIRP notes, that is the format you use — the decision is made. Start here before considering personal preference.
Step 2: Identify your primary payer mix. If you bill primarily to Medicaid or state-funded programs, BIRP notes may best satisfy utilization review requirements. If you work in a medical or integrated care setting, SOAP is the safest choice. For private-pay or commercial insurance, any format works.
Step 3: Consider your clinical population. If you work with clients with serious mental illness or substance use disorders where demonstrating active intervention is critical, BIRP's intervention-response structure is advantageous. If your practice is primarily outpatient psychotherapy, SOAP or DAP will serve you well.
Step 4: Assess your documentation workflow. If you have limited time between sessions, DAP's three-section structure is the most efficient. If you want a format that forces thorough documentation, BIRP or SOAP's four sections provide more structure.
Step 5: Try all three on the same session. Before committing, write one session note in each format. Notice which one feels most natural and which one produces the clearest clinical record. The best format is the one you will use consistently and well.
Common Mistakes
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Choosing a format based on personal preference alone. Your note format should match your setting, payer requirements, and clinical population — not just what you learned in graduate school. A BIRP note in a hospital setting or a SOAP note in a county mental health agency may create friction with reviewers who expect a different format.
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Mixing elements between formats. If you are writing a DAP note, do not add a separate Objective section. If you are writing SOAP, do not embed a standalone Intervention section. Hybrid notes confuse reviewers and undermine the structure that makes each format useful.
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Assuming one format is clinically superior. All three formats can produce excellent or poor documentation. A well-written DAP note is clinically stronger than a poorly written SOAP note. Focus on writing quality within your chosen format rather than debating which format is best.
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Not adapting to your setting when you change jobs. Moving from a private practice (DAP) to a community mental health center (BIRP) requires learning a new format, not insisting on your old one. Budget time to learn the new format's conventions and review examples from your new setting.
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Omitting required elements because the format doesn't have a dedicated section. BIRP notes do not have an Assessment section, but you still need to convey clinical judgment. DAP notes do not separate subjective from objective, but the data should still be organized clearly. Every format requires risk assessment documentation regardless of whether it has a labeled section for it.