Although this book is both practical and innovative, a few limitations should be noted. For instance, despite its stated aim not to examine different ethnic groups, the preponderance of case vignettes are drawn from the Asian population (probably because all but two of the 13 contributors are based at the University of Hawaii School of Medicine or are of Asian heritage), leaving the reader uncertain as to whether the principles and issues discussed really do generalize across groups. In addition, a general definition of culture is used by the authors as a framework within which to assess the different ethnic-racial cultural groups. This might not be sufficient for practitioners working in urban areas who are treating members of diverse ethnic groups exhibiting different stages of acculturation and assimilation, often occurring within one couple or family. In some cases, culture may mask an underlying pathology, and, conversely, psychopathology at times may mask cultural issues. In still other cases, such as a depressed-appearing man who is actually suffering from tuberculosis, the cultural and psychopathological issues may not play a central role.