Against Andy's better judgment, ex-sweethearts Ephram and Madison decide it would be in Delia's best interest if Madison resumed her job as Delia's babysitter. Meanwhile, Amy contemplates going off her anti-depressant medication after Linda suggests she might be ready and Bright anxiously awaits his college acceptance letters.

Amanda decides to send her husband to a very nice treatment facility causing Andy to collapse as a result of stress and guilt over what has happened between him and Amanda. Meanwhile, Amy continues to give Ephram the cold shoulder for lying about Madison, Also Edna builds a writing room for Irv.

The fourth season begins with a nice wedding of an unexpected couple and kiss at the airport for couple Bright and Hannah in Everwood.

Nina finally chooses between the two men she loves - Andy and Jake while at Delia's behest. Amy develops a new friendship with college-age student Reid (guest-star Justin Bardoni) while waiting on her mother Rose at the hospital. Also, Amy and Rose find that Rose's cancer has driven them apart rather than brought them together. Bright flirts with a new girl who might become his roommate, but is more involved in knowing what girlfriend Hannah scribbled off the postcard that she sent to him. Lastly, Ephram makes an emotional return to Everwood just in time for an unexpected wedding.

Andy and Jake are in therapy together with a councillor as they have some issues to settle. Nina leaves them to debate.

Andy consults Josh Stein, who's studying to become a rabbi. Josh also helps Delia with her Bat Mitzvah. Ephram supports Kyle, as his father comes to town. Amy's professor talks to Harold about a medical procedure. Andy is trying to go on a date with someone he met over the internet, but he has to postpone multiple times.