Collaboration with families and communities has been identified as one of six overarching principles to speech and language therapists’ (SLTs’) engagement in culturally competent practice (Verdon et al., 2015a). The aim of this study was to describe SLTs’ collaboration with families and communities when engaging in practice to support the speech, language and communication of children from culturally and linguistically diverse backgrounds. The study also aimed to identify the benefits and tensions related to such collaborations and to describe opportunities for SLTs to enhance their cultural competence through collaborative practice. The current study drew upon three data sources collected during the ‘Embracing Diversity – Creating Equality’ study: field notes, narrative reflections by the researcher, and semi-structured interviews with SLTs. This study was conducted in 14 international sites across five countries (Brazil, Canada, Hong Kong, Italy and the USA), representing a diverse range of cultural and practice contexts. Cultural-Historical Activity Theory (CHAT, Engeström, 1987) was used as both an heuristic framework through which the study was conceptualized and as a tool for analysis to describe the varied nature of collaboration in different cultural contexts, the benefits of collaborating with families and communities, and the tensions that can arise when engaging in collaborative practice. The results illuminate the importance of SLTs’ collaboration with families in order to gain an understanding of different cultural expectations and approaches to family involvement, and to build partnerships with families to work towards common goals. Collaboration with communities was highlighted for its ability to both facilitate understanding of children’s cultural context and build respectful, reciprocal relationships that can act as a bridge to overcome often unspoken or invisible tensions arising in cross-cultural practice. The findings of this study highlight opportunities for professionals to enhance the cultural competence of their practice through engagement with families and communities.