Another session of Couples Therapy has come to an end.

The Showtime docuseries first premiered in September 2019, with the intimate reality show finishing its fourth season on June 13.

Created by the filmmakers Josh Kriegman, Elyse Steinberg and Eli Despres, the project features therapist Dr. Orna Guralnik as she meets with multiple couples, who volunteer to have their intimate therapy sessions filmed for TV cameras, while they work on their relationships.

In a May 2023 essay for The New York Times Magazine, Guralnik said she was drawn to the Couples Therapy project “knowing that the directors were committed to an honest, vérité portrayal of therapy, and to looking at the social factors that thread through people’s lives and relationships.”

Since the series’ debut, viewers have had questions about the true details behind it, like whether it is scripted.

So is the show Couples Therapy real? Here’s everything to know about the Showtime docuseries, including if Guralnik is a licensed therapist working with real-life people.

What is the show Couples Therapy about?

Couples Therapy stars psychoanalyst Dr. Orna Guralnik, as she guides couples through emotional and revealing therapy sessions with each other.

According to the official series synopsis, “The show strives to present the participants and the therapy process with empathy and not sensationalism. As viewers track the couples’ progress with Dr. Guralnik through each episode.”

Thanks to cameras hidden in the show’s set, viewers of Couples Therapy are able to sit in on raw conversations that are usually kept behind closed doors.

Is the show Couples Therapy real?

Yes, Couples Therapy actually shows couples filmed during therapy sessions that span multiple weeks.

But while the show’s therapy sessions are real, the office it’s set in is not: Guralnik’s TV workplace is actually built on a soundstage in Brooklyn.

In a September 2019 Vulture feature, co-creator Kriegman said, “We created an office where the cameras actually were concealed behind one-way glass.”

“They could come in, sit in the waiting room, do an hour session with Orna, leave, and never once interact with any element of production or see a camera,” he explained.

The next summer, in a July 2020 Vulture article, fellow creator Despres explained how the Couples Therapy team “wanted to be able to capture anything that was happening with our subjects, any time, from any direction.”

“That really put us in this 360-degree shooting setup,” he added. “That need dictated everything that followed.”

Who is the doctor on the show Couples Therapy?

Couples Therapy features Dr. Orna Guralnik, a clinical psychologist and psychoanalyst based in New York City. She is also a faculty member at New York University’s Postdoctoral Institute for Psychoanalysis, per her website.

As she told The New York Times Magazine in May 2023, she has “been working as a psychologist seeing individuals and couples since the mid-1990s.”

According to the Chicago Tribune, Guralnik “typically charges $700 per session” at her practice. In a May 2022 interview with The Cut, Guralnik said she has long-term patients who she sees “twice or three times a week.”

Viewers looking to book a session with Guralnik can apply for the next season of Couples Therapy. The application asks potential participants to provide basic information like their name, partner’s name, how long they’ve been together and reason “for seeking couples therapy.”

In a May 2024 interview with HuffPost, Guralnik admitted that juggling her private practice clients and Couples Therapy has “been hard” but rewarding.

“It’s been an enormous amount of work. I’ve had to adjust to being a public person, which is not in my nature,” she continued. “My actual patients in my private practice have suffered from this, kind of sharing me in this way. So it’s not been without a price. But overall, it’s been a really, really good experience.”

Does the show Couples Therapy have real couples on it?

Yes, the people on Couples Therapy are real.

According to a September 2019 Vulture feature, throughout the show’s casting process, producers interview “more than 1,000 couples,” looking for people “who truly wanted to get therapy.”

Guralnik added that when it came to finding potential couples, “It had to be people who were well enough to withstand the pressure and anxiety of this project … We didn’t want to take people who were vulnerable and this could unravel them.”

Viewers meet the couples when they walk in the therapy office, and so does Guralnik. As she explained in a June 2024 Reddit AMA, she “basically [gets] a one paragraph summary” of them before their first meeting.

As for life post-Couples Therapy, not all of the relationships survive. According to The New York Times, season 1’s Lauren Guilbeaux and Sam Hopwood have split.

Will there be a season 5 of Couples Therapy?

In June 2025, Couples Therapy was renewed for a fifth season.

It is currently unknown when season 5 will premiere, but the first part of season 4, consisting of nine episodes, aired in June 2024. The second part of season 4 premiered in May 2025, concluding on June 13.

When Paramount announced the season 5 renewal news in June 2025, following the season 4B debut, it stated that there was a “+30% increase on cross-platform viewership vs. prior season premiere.”

Where can I watch Couples Therapy?

Couples Therapy airs on Showtime and is available to stream on Paramount+ with Showtime.