...To Change the Things I Can is the season four finale and the 76th overall episode of Private Practice.

Short Summary

The doctors of Oceanside Wellness are faced with a tough decision -- to point out all areas of vulnerability within the practice and risk the termination of some of their own, or to dissolve the practice and each go their separate way. Addison has a new admirer in town who offers her a very tempting proposition. Meanwhile, Charlotte is assigned to a case that hits very close to home.

Full Summary

Episode in detail.


  • Addison Montgomery
  • Pete Wilder
  • Naomi Bennett
  • Cooper Freedman
  • Charlotte King
  • Sheldon Wallace
  • Amelia Shepherd
  • Sam Bennett
  • Violet Turner
  • Jake Reilly
  • Gabriel Fife
  • Jason Windsor
  • Angela Windsor
  • Neal Chaplin
  • Betsey Parker
  • Kaitlan Mills
  • Marisa Windsor
  • Gate Agent
  • Nurse and Charlotte King
  • OR Nurse

Main Cast

Special Guest Star

Guest Stars


Medical Notes


Song Performer Scene
"Easier Said Than Done" Morcheeba
"Time To Go" Sara Swenson
"I Saw a Stone" The Rocketboys
"I Don't Know" Shelly Fraley
"Make a Noise" Katie Herzig

Notes and Trivia

Private Practice 4x22 - PROMO - ..

Private Practice 4x22 - PROMO - ...To Change the Things I Can

  • This episode scored 7.45 million viewers.
  • This episode's title originated from the serenity prayer.
  • The serenity prayer has been adopted by Alcoholics Anonymous, so it's most likely a reference to Amelia who starts drinking again.
  • This episode marks the last episode in which Audra McDonald is credited as a main cast member.
  • This episode features a guest appearance by Joshua Malina, who portrays David Rosen in Shonda Rhimes's other TV show Scandal.
  • Addison starts seeing her therapist, which becomes recurring throughout the fifth season, where she visits her shrink almost every episode. However, in this episode, the shrink is played by Kevin Koster, while in the fifth season, he's played by Scott Alan Smith.
  • This episode marks the introduction of Dr. Jake Reilly. It's the first and only episode in which Benjamin Bratt, who portrays Jake, is credited as a special guest star rather than main cast.


Episode Stills


See Also

A complete overview of this episode's crew can be found here.

Community content is available under CC-BY-SA unless otherwise noted.