This paper, based on a broad body of relevant data, presents a dialogue that explores and integrates two important concepts: family and culture. An understanding of these concepts is important for enhancing occupational therapy practice, in particular a practice that claims to be client-centered and holistic. The dialogue focuses particularly on issues students involved in the Intercultural Interaction Project, The University of Sydney, Australia, in 2002 identified as important. These include: a lack of understanding of the concept of culture, the confounding of culture and ethnicity, considering culture as an issue only in families from “other” cultural backgrounds, assumptions about the nature of families and therapists’ points of reference for making these assumptions, differences in client or family and therapist expectations, and how these expectations affect what happens in therapy and participants’ level of satisfaction with the outcomes of the interactions involved. The information suggests that there is a need for a better understanding of how culture influences ideas about families and how to work with them.