PIRP Note Example

Trauma Treatment Without Reliving the Pain

Client worked on trauma healing using a stabilization-first approach, focusing on present triggers and nervous system regulation.

Generated PIRP Note:

Quill generated this note with AI from the summary that was provided. The therapist can then copy-and-paste the note into their current EHR platform.

Problem:
Client expressed a desire to work on trauma but reported fear of discussing it in detail, stating, "I don't think I can handle going through it all again." Client reported symptoms of nightmares, flashbacks, and hypervigilance, and expressed concern that addressing the trauma might worsen these symptoms. Client identified crowded places and sudden loud noises as present-day triggers.

Intervention:
50-minute session held in the office. Therapist reassured client that trauma healing does not require reliving the pain and introduced a stabilization-first approach. Therapist worked with client to identify present-day triggers and facilitated resourcing by guiding client to visualize a safe place, described as her grandmother's garden. Therapist also introduced nervous system regulation techniques, including slow breathing and body awareness exercises.

Response:
Client appeared relieved upon learning that trauma healing could focus on stabilization and resource-building rather than retelling the trauma narrative. Client actively engaged in identifying triggers and creating a safe place visualization. Client expressed feeling like she could manage the process, stating she "feels like she can actually do this now."

Plan:
Client assigned homework to practice safe place visualization daily and to notice triggers without judgment. Continued focus on stabilization and nervous system regulation is planned for future sessions. Trauma processing may be introduced when client feels ready and sufficiently resourced. Next session scheduled for next week.

Client Session Summary:

Here's the summary of this client session. Remember, Quill does not record the client session. A therapist would provide a summary (like the one below) after the session is over, and then Quill would generate a note similar to the one above.

We had a 50-minute office session today. Nina came in and said she's been wanting to work on her trauma, but she's really scared of having to talk about it in detail. She said quote 'I don't think I can handle going through it all again' unquote. She's been having symptoms, nightmares, flashbacks, hypervigilance, but the idea of retelling the story feels overwhelming, and she's worried it'll make things worse.

I reassured her that trauma healing doesn't have to mean reliving the pain. We can work on the symptoms and help her feel safer in her body without doing intensive trauma narrative work. I explained that we'd use a stabilization-first approach, focusing on what's happening for her now and building up her resources before we ever go near the details. She seemed really relieved to hear that.

We started by identifying her present-day triggers, situations, sounds, smells, or feelings that set off the trauma response. She said crowded places and sudden loud noises are big ones. Then we worked on resourcing, I asked her to think of a place, real or imagined, where she feels completely safe. She described her grandmother's garden, and we spent some time building that image in detail so she could use it as an anchor when she feels triggered. We also did some nervous system regulation work, practicing slow breathing and noticing where she feels calm or neutral in her body, so she can start to build a sense of safety from the inside out.

Her homework is to practice going to her safe place visualization once a day, and to notice her triggers this week without judgment, just tracking them. We'll keep working on stabilization and regulation, and we won't move into trauma processing until she feels ready and resourced enough. She said she feels like she can actually do this now. We'll meet again next week.

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More About PIRP Notes:

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