- Two case studies of Arab Muslim Palestinian couples who had lived in North America and returned home to the West Bank, Palestine, are presented. The first case study shows the tension of returning home and having North American values conflict with traditional Arab Muslim world values. The second case sheds insight into the strain of a family returning home and experiencing the conflict with tradi¬tional values. The cases show how patriarchy is malleable over time and place. They likewise highlight the importance of gender, patriar¬chy, family, extended family, and community influences on couples’ experiences of acculturation and reacculturation: a process of dou¬ble transition, where conflict, confusion, disharmony, and disinte¬gration may arise at two stages, and where a cumulative impact from acculturation to reacculturation may occur. The conclusion high¬lights how clinical intervention needs to be culturally responsive and acutely sensitive toward the rights of women.