‘In Treatment’ is Back and in Top Form with Uzo Aduba

HBO’s therapy session drama returns after a decade off the air with a new cast and whip-smart and timely fourth season.

Welcome to Previously On, a column that gives you the rundown on the latest TV. This week, Valerie Ettenhofer reviews the revival season of the HBO drama series In Treatment.


Ever since Tony Soprano first walked into Dr. Melfi’s office, it’s been obvious that therapy makes for good TV drama. In the decades since The Sopranos first hit the airwaves, we’ve seen all manner of small screen therapists, from the genuinely helpful to the truly deranged. But no show has focused as squarely on the practice of talk therapy as HBO’s In Treatment. The innovative series takes place almost entirely in real-time fictional therapy sessions and airs multiple episodes per week to mimic a therapist’s real work schedule. After more than ten years off the air, the series is back, and it’s the rare revival that makes itself not only essential but possibly even superior to the original.

Uzo Aduba leads the fourth season of In Treatment as Brooke, a Los Angeles-based therapist who is seeing patients in her home and via video calls during COVID. Viewers who haven’t seen the past seasons of the series needn’t worry about jumping in blind; Gabriel Byrne’s Paul Weston, the series’ original lead, is little more than a thin connective thread to the latest iteration. Viewers get up close and personal with three of Brooke’s new clients: Eladio (Anthony Ramos) is a possibly bipolar, insomniac home health aid; Colin (John Benjamin Hickey) is a wealthy, quick-tempered businessman whose recent release from prison depends on his psych writeup; and Laila (Quintessa Swindell) is a Black, queer, teenaged dreamer who is dragged to therapy by her intimidatingly traditional grandmother. Each week ends with a fourth episode, in which Brooke unpacks her own considerable baggage with an old friend, Rita (Liza Colón-Zayas), and a lover, Adam (Joel Kinnaman).

In Treatment has always been an actor’s showcase, and Season 4 is no exception. Aduba’s performance as Brooke is a layered challenge for the Emmy-winning actress, one she rises to meet with ease. In the sessions, Brooke can go from likable and good-humored to boundary-pushing in an instant. As with most fictional therapists, she often plays fast and loose with therapeutic best practices — if the season has a weak spot, it’s an occasional, soapy lack of realism during sessions — but she’s also thrillingly tactical, countering every questionable move with a bout of radical honesty that keeps her clients coming back.

Shows like In Treatment put audiences’ attention at risk by cycling through focal point characters (i.e. the weaker early episodes of Lost) but this season, there’s not a dull patient in the bunch. Ramos’ performance as Eladio, a man who feels deeply and is wounded easily, is both magnetic and enigmatic. Meanwhile, non-binary actor Swindell joins the ranks of then-up-and-comers like Season 1’s Mia Wasikowska and Season 3’s Dane DeHaan, young performers who steadily reveal their star power when given time in the series’ focused, slow-burn spotlight.

Hickey is the season’s firecracker, playing one of the show’s trickiest, most impressively nuanced characterizations to date. Colin is a self-pitying narcissist, the kind of privileged white guy who feels suffocated by the idea that other people might be offended by the offensive things he loves to say. As a disgraced public figure, he’s hyper-aware of his place in the discourse, and bristles against the world’s — and Brooke’s — judgment. When the men who massively screw up deliver a public apology saying they’ll be taking time away from the public eye to “listen and learn,” where do they go? It’s not something most of us have to think about, but In Treatment shows us the obvious answer: they go to therapy.

Hickey’s performance is utterly compelling. It’s impossible to tell whether Colin is about to scream, cry, or come onto Brooke, and when he does pick a move, it’s almost as impossible to tell if it’s genuine. In yet another structurally unique element, each of In Treatment’s character arcs features a different credited writer. Zack Whedon scripted Colin’s episodes, which often evolve into ferocious tête-à-têtes or surprising admissions, with a whip-smart sense of dialogue and a refreshing level of consideration for a subject that has long since lost its nuance in public conversation.

The new season of In Treatment isn’t just good drama, it’s also TV at its smartest. Sure, some of the characters make foolish decisions, but the show itself is written in a rare way that engages the intellect, challenging viewers to immerse themselves in the ever-more-complicated perspectives of Brooke’s patients. It would’ve been easy for In Treatment to focus its narrative on changes to technology that have impacted the world this past decade, but instead, it’s the antithesis of social media, doing the hard work of imagining humans as multi-faceted and contradictory — loveable, one minute, and appalling the next.

Brooke is the perfect character to navigate us on this journey. As a well-off but troubled Black American woman, she clearly code-switches between patients, highlighting and de-emphasizing parts of her identity as needed in order to feel safe and gain trust. The series also weaves in major cultural moments like the coronavirus pandemic and the murder of George Floyd with a near-effortlessness that other series could take notes on.

In Treatment‘s fourth season is a one-of-a-kind experience, clever and entertaining and both structurally and narratively daring. Like real-life therapy, it’s messy, challenging, and absolutely worth your time.


Season 4 of In Treatment premieres on HBO and on HBO Max on May 23rd. 

Valerie Ettenhofer is a Los Angeles-based freelance writer, TV-lover, and mac and cheese enthusiast. As a Senior Contributor at Film School Rejects, she covers television through regular reviews and her recurring column, Episodes. She is also a voting member of the Critics Choice Association's television and documentary branches. Twitter: @aandeandval (She/her)