The Dutch Centre for Consultation and Expertise (CCE) is available to support refractory cases in Mental Healthcare Services.This descriptive mixed methods study gains insight into the commonalities underlying the reasons of 472 consultations and the solutions proposed that play roles in (the reduction of) refractory cases for which consultation has been requested.83% cases in the sample could be explained with four exemplary situations involving self-harm (24.2%), aggression (21.8%), self-neglect (24.4%), and socially unacceptable behavior (12.5%), respectively.The main conclusion is that refractory situations involve interaction patterns that inadvertently perpetuate or even exacerbate them.Professionals’ adoption of an interpersonal behavioral style with attention to daily routines and meaningful activities was an essential part of all possible solutions to the refractory situations in this study. This behavioral style can be challenging for professionals because they are sometimes counterintuitive. The presented solutions to refractory situations imply profound relevance for clinical practice.