This study mainly explores the ethical issues and decision-making experiences of counselors working with Borderline Personality Disorder clients. There are three research participants who have ten more years of professional working experience at a medical institution, university and community organization in this study. Data were collected in semi-structured interviews, and were analyzed by content analysis. The results are as follows:
Counselors are faced with Ethical issues when they are working with Borderline Personality Disorder clients, such as "High-Risk Impulsive Behavior", "Unstable Counseling Framework", "Difficulty in Boundary Management", "Unstable Counseling Relationships" and "Discrepancy of ethics between counselor and client's understanding".
"High-Risk Impulsive Behavior" refers to the feelings of panic, nervousness and stress which participants experience. Maintaining a clients’ life as the main principle, participants conduct professional assessments and provide different interventions according to different stages in combination with surrounding resources and a multi-consideration attitude. "Unstable Counseling Framework" refers to the feelings of powerlessness which participants experience. However, the participants still maintain the attitude that they respect the clients’ decision and accept it as it is. They try their best to maintain the framework with flexibility. "Difficulty in Boundary Management" refers to the experience of dilemma and the feelings of powerlessness. The participants empathize with the behavior of clients crossing the boundary which they stick to and seek the assistance of a professional system of cooperation and consultation. "Unstable Counseling Relationships" refers to the feelings of self-doubt and countertransference. The countertransference is handled by professional resources such as counseling supervision. In "Discrepancy of ethics between counselor and client's understanding", there is a huge gap in the perception of suicide prevention strategy between the counselors and the clients. The clients consider that the suicide prevention strategy deprives them of their rights, while the counselors believe that the suicide prevention strategy is fulfilling their working commitments.
After the experience of ethical issues which participants have been through, their reflections on the experience include "Rethinking Counseling Values", "Emphasize Systematic Cooperation" and "Reconfirming Self-belief".
Based on the results, this study puts forward suggestions for related research or psychological practitioners.
