DESCRIPTION (provided by applicant): The DBT-Accepting the Challenges of Exiting the System (DBT-ACES) advanced year of DBT has been designed specifically for psychiatrically disabled individuals with severe borderline personality disorder to assist them to achieve recovery as recommended in the President's New Freedom Commission on Mental Health. DBT-ACES has been shown in pre-post evaluation to increase both employment and self-sufficiency. This R34 treatment development study further evaluates the feasibility and acceptability of DBT-ACES and of the randomized controlled trial study procedures for a possible future efficacy trial. It has three specific aims: (1) to further develop the DBT-ACES manual including its feasibility and treatment fidelity, (2) to develop the means for and evaluate the feasibility of an efficacy trial of DBT-ACES in terms of recruitment, attrition, assessment, and a treatment-as-usual (TAU) control condition, and (3) to conduct a small randomized clinical trial pilot study of DBT-ACES (n=15) vs. TAU (n=15) which will evaluate attrition rates for DBT-ACES and TAU and the statistical feasibility of studying experimental effects of the treatments on primary and secondary measures. Because DBT-ACES is an advanced DBT treatment, study participants will all receive standard DBT (paid for by county public mental health funds) and then those who are stable and interested in employment will be randomized to DBT-ACES or TAU for a second year of treatment.