Note Examples
Example GIRP Note

Example GIRP Note

GOALS
Discussed Goals:

  • Goal 1:
    • Goal Description: Better understand and manage anxiety symptoms.
    • Metrics: Reduce panic attack frequency and self-reported anxiety levels.
    • Attainability: Attainable with client motivation and consistent practice of CBT and mindfulness techniques.
    • Relevance: Highly relevant to improving client's quality of life and functioning.
    • Timeframe: Expect regular progress over 8-12 weeks.
    • Quote (Goal): “The anxiety has such a grip on my life right now. I’ll know I’m better when I break free from its constant presence.”
  • Goal 2:
    • Goal Description: Improve ability to speak up for needs and set boundaries.
    • Metrics: Increase assertive responses during role plays and real-life situations. Reduce people-pleasing behaviors.
    • Attainability: Attainable through self-compassion exercises, assertiveness training and cognitive restructuring.
    • Relevance: Important for managing anxiety, improving relationships and boosting self-esteem.
    • Timeframe: Expect gradual improvement over 8-12 weeks.
    • Quote (Goal): “I put too much pressure on myself to make others happy all the time. I need to learn how to put my needs first.”
  • Barriers To Achieving Goals: Lack of self-compassion, low distress tolerance, and avoidance behaviors may hinder progress if not addressed. Social anxiety also makes it difficult for her to speak up.

INTERVENTIONS

  • Therapeutic Approach Or Modality: Cognitive-behavioral therapy, interpersonal therapy
  • Psychological Interventions:
    • Validated feelings.
    • Encouraged challenge of automatic thoughts.
    • Assigned thought tracking.
  • Rationale: Increase awareness of cognitive distortions fueling depression. Begin the process of identifying and challenging automatic negative thoughts.

RESPONSE

Progress and Response:

  • Response To Treatment: The client displayed limited engagement and motivation for change.
  • Specific Examples Or Instances: Client keeps deflecting from talking about certain issues.
    • Quote (Progress): "I don't know, I don't think I can."
  • Challenges To Progress: Lack of motivation and avoidance of social connections will likely impede progress. Negative automatic thoughts and cognitive distortions will also pose a challenge.
  • Therapist Observations And Reflections: Client is fused with their negative thoughts, might need to introduce defusion techniques.
  • Therapeutic Alliance: The client showed some resistance. She was hesitant to talk about certain things related to her anxiety. The therapist processed that with her.

PLAN
Follow-Up Actions And Plans:

  • Homework: Complete thought records identifying automatic negative thoughts and labeling cognitive distortions. Engage in one social activity.
  • Plan For Future Session: Review thought records, continue cultivating motivation and self-efficacy, begin discussing behavioral activation steps.
  • Plans For Continued Treatment: Continue weekly therapy, consider psychiatric referral if lack of progress.
  • Coordination Of Care: No coordination of care indicated at this time.