PIE Notes for Therapists: Format, Examples, and When to Use Them

PIE notes organize clinical documentation around three elements: Problem (the clinical issue addressed), Intervention (what you did), and Evaluation (how the client responded). Originally from nursing, PIE notes are used in some mental health and community care settings where the focus is on problem-solving and measurable response rather than a broader clinical narrative.

The three sections

P — Problem

The specific clinical problem or goal addressed in this session. Often linked directly to a treatment plan goal.

Example: "Problem: Panic disorder with agoraphobia. Client reports two panic attacks in the past week, both triggered in supermarkets."

I — Intervention

What you did to address the problem: techniques, psychoeducation, skills.

Example: "Reviewed interoceptive exposure rationale. Practiced diaphragmatic breathing and cognitive restructuring of catastrophic thoughts ('I'm going to faint'). Designed graded exposure hierarchy for supermarket situations."

E — Evaluation

How the client responded: immediate response to intervention, any change in the presenting problem, safety.

Example: "Client engaged well with exposure rationale; initial anxiety about the hierarchy reduced as tasks were broken down into small steps. Reported feeling 'more in control' by end of session. No safety concerns."

When to use PIE notes

PIE works best when:

• Your setting requires explicit problem-goal linking in documentation
• You want a very focused, brief note structure
• The session was tightly problem-focused (skills training, brief intervention)

PIE is less suited to:

• Complex, multi-problem presentations
• Psychodynamic or relational therapy where the work is harder to reduce to problem statements
• Settings requiring detailed client narrative (insurance reviews often prefer SOAP)

PIE vs SOAP vs DAP

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See also: SOAP vs DAP Notes and BIRP Notes: Complete Guide.