Table 2 Overview of patient-related and professional-related factors in treatment (dis)continuation decisions

Stability

Degree to which the patient functions without crisis for at least some time, and the ability to cope effectively when problems arise or stress increases.

‘I can stop because I feel more stable and I now have a steady relationship with someone’ (P, Interview3)

‘First work on stabilization (…). Later we can discuss termination, but first we need to relieve pressure’ (PSA, TeamMeeeting12)

‘She can come to see me if she feels that will keep her stable’ (CMHN, TeamMeeeting5)

Trust

Degree to which the professional believes that the patient will be able to cope with future difficulties

‘Too much hassle to terminate treatment, she will definitely be back if we do’ (CMHN, TeamMeeeting20)

Risk

Degree to which there is:

1) danger to the patient and/or others

2) other risk: relapse, deterioration

‘It feels sound. They can let me go now, I can go on. By myself I mean, without them’ (P, Interview11)

‘We are not done with him until the threat becomes less’ (SW, TeamMeeeting6)

‘No termination! He is a real loony, dangerous, much drug use in the past’ (SW, TeamMeeeting17)

Fear

The feeling that ‘things may go wrong’ with the patient

A professional (non-psychologist) on others:

‘Psychologist are chickens, they never dare to terminate treatment’ (CMHN, Interview5)

Motivation

Degree to which patient is willing and able to work hard to reach improvement

‘He is now motivated but that can easily turn around, and then I don’t know if we should continue’ (PSO, TeamMeeeting15)

‘As long as he is so unmanageable we cannot discuss anything with him. We should stop’ (PSO, TeamMeeeting11)

Reward

Degree to which the professional feels that the patient deserves another chance in treatment

‘This lady does not fit in my treatment program but she is nice broad and I’ll give her another chance’ (CMHN, TeamMeeeting23

‘She is avoidant, last November we agreed that she would call me but she has not. So it would be best to end care now’ (PSA, TeamMeeeting14)

Hope

Degree to which the patient has hope that treatment will result in improvement

‘I have to tell him that he cannot expect anything of us anymore. That the problems lie elsewhere, that he has to accept things as they are. But he does not seem open to that’ (PSO, Interview4)

‘It will not go away, but I have learnt to deal with that. In that I have succeeded’ (P, Interview11)

Perspective

Degree to which the professional beliefs that treatment will result in improvement

‘He does not agree with us that further treatment will not help. He really wants to quit using substances. So we are going to try another treatment and see if it works’ (physician, TeamMeeeting2)