How to Write a PIE Note: A Therapist’s Guide

Of all the different therapy note types, this is certainly the one that sounds the most delicious (tastier than a SOAP note for sure)! In mental health documentation, the PIE note format is a streamlined option that emphasizes clarity, brevity, and connection between therapeutic work and outcomes. “PIE” stands for Problem, Intervention, and Evaluation. Though less detailed than some other formats (e.g. SOAP, DAP, PIRP), PIE notes can be effective in many settings -especially when caseloads are high or you prefer a more focused note style. However, even within such a concise structure, it’s critical to demonstrate medical necessity, interventions used, and to document the client’s response and ongoing need for care. Below I outline a clinician-friendly approach to writing PIE notes with prompts to guide you through the PIE writing process.

P: Problem

This section states the client’s presenting issue(s), symptoms, or challenges – ideally tied to functional impairment, distress, or the rationale for therapy.

👩🏻‍💻 Clinician Cue Questions:

• What is the main problem or concern the client presented today?
• How has this problem changed (or not) since the last session?
• In what ways does this problem interfere with the client’s daily functioning (e.g. sleep, work, relationships)?
• What specific behavioral, emotional, or cognitive signs support the presence of this problem?
• What justifies ongoing treatment (i.e. medical necessity) given these symptoms or impairments?

Tips / Notes:

• Be specific: avoid vague phrasing like “client distressed”—instead note what form distress takes (e.g. trouble sleeping, irritability, concentration difficulties).
• Tie the problem to the client’s functioning or life domains to justify continuing care.
• If the problem is stable or chronic, note whether it is cyclical or refractory, and why it still warrants treatment.

I: Intervention

Here you document what you (the therapist) did during the session to address the problem(s). Specify the techniques, therapeutic rationale, tasks, or skills introduced or reinforced.

👩🏻‍💻 Clinician Cue Questions:

• Which therapeutic approach(s) or strategies did I use today (e.g. CBT, DBT, motivational interviewing, narrative, mindfulness)?
• What specific techniques or exercises did I guide the client through (e.g. thought logs, exposure, role play, behavioral activation)?
• What was the rationale behind selecting these interventions or how do they map to the problem(s)?
• Did I assign between-session or homework tasks (journaling, behavioral experiments, exposures)?
• Did I provide psychoeducation, reframing, or coping tools?

Tips / Notes:

• Use action verbs and link interventions to the problem (e.g. “guided client to challenge negative prediction thoughts” rather than just “cognitive work”).
• Even brief interventions count; document short exercises, check-ins, or reframing you did.
• Keep it clinical and clear – this is where you show your therapeutic work.

E: Evaluation

This is your assessment of how the client responded to the interventions and whether they made any observable or reported progress. It also may include plans or next steps (if you choose to embed a mini-plan in this section).

👩🏻‍💻 Clinician Cue Questions:

• How did the client react to the interventions? (verbally, emotionally, behaviorally)
• Did the client show insight, resistance, hesitation, or openness?
• What changes (if any) were observed during the session (mood shifts, reduced tension, new perspective)?
• Did the client demonstrate understanding or readiness to apply new skills?
• What remains unresolved or needs further focus next session?
• Based on the evaluation, is continued therapy still warranted (medical necessity)?

Tips / Notes:

• Use objective or observed language (e.g. “client’s voice steadied,” “client paused and reflected,” “noted reduction in muscle tension”).
• Be honest: if the intervention didn’t fully land, that’s okay—document what challenges remain.
• If you prefer, you can append a brief “next steps” or “plan” line here (even though PIE doesn’t formally require a separate Plan section). Many therapists naturally include a sentence about where you’ll go next.

Sample PIE Note:

Here is an example of a PIE note from a fictional therapy session.

Client: Elliot Alderson (pseudonym)
Date of Session: October 23, 2025
Duration: 45 min.
Start time: 9:00 am
End time: 9:45 am
Diagnosis: F44.81 Dissociative Identity Disorder
CTP Code: 90834 (Psychotherapy 45 min)

Clinician (signed):
Krista Gordon, Ph.D.
Electronic signature: Oct 23, 2025, 4:00 PM

When is PIE format a good fit?

Strengths & ideal scenarios:

• When you want a lean, efficient documentation style.
• In high-volume or fast-paced clinical settings.
• For more structured, goal-oriented therapeutic approaches (e.g. CBT, behavioral activation).
• When continuity among clinicians is needed: the PIE format is easy to scan and follow.

Limitations / situations where PIE may be insufficient:

• Complex cases requiring more narrative, safety planning, or extensive assessment.
• Legal, forensic, or highly regulated cases where more detailed documentation (e.g. DAP, SOAP, PIRP) is expected.
• Settings requiring a separate Plan section or more robust future-planning documentation.
• When more context or background is essential (e.g. multiple diagnosis, comorbidities, crisis history).

Of course, you can always augment PIE notes with an addendum or link them to a fuller psychosocial assessment or treatment plan document.

How Note Designer Can Help

Note Designer makes it easy to create professional PIE notes with ready-to-use, fully customizable templates. Each section—Problem, Intervention, and Evaluation—includes smart drop-down content you can tailor to fit your clinical work. You can write entirely on your own or, if you choose, use our optional and ethical AI feature to refine and polish your note after you’ve selected or entered your content. Whether you prefer structure or flexibility, Note Designer helps you document efficiently while maintaining accuracy, compliance, and your authentic clinical voice.

Patricia C. Baldwin, Ph.D.

Clinical Psychologist

President of

Note Designer Inc.

👩🏻‍💻 Author of Note Designer: A simple step-by-step guide to writing your psychotherapy progress notes (2^nd Edition- updated and expanded); 2023

© 2026 Patricia C. Baldwin. All rights reserved.

For more guidance on how to write different types of progress notes and reports, check out my other blogs listed here: