Contains spoilers for this episode and earlier episodes.
Joanna arrives after Otis asks her to help Jean with Joy, but the sisters immediately disagree about how much help she is actually providing. At Cavendish, Otis expands his clinic and competes with O for students' attention. Ruby suggests that helping Roman and Abbi could improve his reputation, and his conversation with Roman draws new clients. When O proposes working together, Otis instead suggests an election to decide which of them should remain the college's therapist. Ruby offers campaign help, but his assumption that she wants him back angers her. He eventually calls her after seeing how confidently O is campaigning.
Maeve tries writing more directly from her own experience after Molloy challenges her ideas. He asks for her opinion on his work and agrees to read her new pages, encouraging her to hope for an internship. Otis becomes upset at the possibility that she might stay in America, and another argument leads them to take space. Eric talks with Abbi about faith and rejection while considering baptism. Adam starts work at a horse farm after exaggerating his skills, then admits that he cannot ride or drive. Michael offers driving lessons after an uncomfortable family meal. Jackson worries about a lump discovered during a casual encounter, and Otis encourages him to get it checked rather than dismissing his concern.