Reviews the cultural conflicts encountered in the therapeutic setting when dealing with immigrant Arab-Americans, focusing on the health care professional's limited knowledge of the patient's culture and language and the lack of mutually understood symbols. It is asserted that there is a need to clarify roles, expectations, and cultural differences with the family, patient, and staff at the time of an Arab-American's admission to the hospital; the family's unrealistic expectations of Western medicine and perceptions of mental illness and hospitalization should also be addressed. It is suggested that the family should be enlisted as a major coping device for the Arab-American patient. A case example of a 33-yr-old Iraqi man and his nursing care plan is presented to illustrate the importance of designing an individualized care plan for patients that incorporates an Arabic culture consultant to translate for the staff the symbolic meanings of behavior and action and to clarify cultural properties. It is suggested that the key to successful therapy is consistent adherence to a care plan by staff and family members, a view toward achieving independence and discharge from the start, and empathy for the difficulties faced by the immigrant patient and his/her family.