The world is changing very fast toward cultural pluralism. It is predicted that most of the societies will be more diverse in 21st century. Cultural differences denied for centuries in therapeutic interventions are no more acceptable. Multicultural counseling and therapy are in fact a strong trend in response to this urgent need. That is the reason for multiculturalism to be considered the fourth force in psychology. All counseling and therapy issues and interventions are somewhat cross-cultural. How a client views the world is important insofar as it contrasts with the counselor’s. Many Eastern and Western cultures are considered different according to different perspectives. Family as a powerful social institution is the matrix of cultural identity of its members. In recent years, culture turned to occupy a key position in family therapy. Couples have learned to identify with cultural values and biases of their own families throughout their childhood. Family counselors and therapists as well as all their counterparts need to develop activities and intervention techniques to counteract these biases. Development of multiculturalism transformed how many therapists think and work with families. This article deals with cultural issues and dementions of counseling and therapy East and West, with more emphasis on couples and families. Key words: Multiculturalism, Counseling, Marriage and Family Issues.