DBT–ACES in a multicultural community mental health setting: implications for clinical practice

Abstract This chapter expands on the dialectic between the delivery of dialectical behavior therapy–accepting the challenge of exiting the system (DBT–ACES) and cultural intersectionality. The aims of DBT–ACES, a second-stage treatment aimed at helping clients with borderline personality disorder, are to support clients in continuing to aspire for a life worth living, secure economic independence, and ultimately break free from psychiatric disability. This chapter focuses on multicultural barriers that may arise during treatment. Program data from a culturally diverse treatment sample are reviewed. A review of the literature on the importance of considering multiculturalism in the delivery of DBT and cultural adaptations are suggested for clinical practice. Case examples are provided to highlight these concepts.