But Jenn Berman, the no-nonsense psychotherapist behind the show, says they're coming along as a couple.
"Juan Pablo and Nikki have evolved through their therapy," she tells PEOPLE. "But there's more work to be done. There are some specific things about Juan Pablo that have caused him to hold back, but both he and Nikki open up more and more as they go through therapy."
Lesson No. 1? Stop being so concerned about public opinion.
"I've told them to stop reading blogs and fan sites about them. I don't think it's in their best interest for them to look at the things that people say about them online," she says. "Juan Pablo has a very thick skin and is able to intellectualize things a little bit, so it affects him less. Nikki is a nurse from Kansas; it's unfamiliar territory for her. They live in a fishbowl, and that makes it hard."
Ferrell, in particular, has struggled while watching the show, even taking a hiatus from Twitter and other social media. In the five seasons of Couples Therapy, Berman has seen it before – and says Ferrell's reaction comes as no surprise.
"We had an amazing and intense period [of counseling] that felt very private," she says. "When it airs, I struggle a little bit because it's so personal. When it's on TV, it's very hard to see how you might come across during these private moments."
As for the future of their relationship? "They are both really trying to make this work," says Berman, who also runs a private counseling practice and has her own radio show on the Oprah Network. "It's a process; I think that we all owe it to ourselves and our partners to be constantly working on ourselves. We should be evolving and growing. And Juan Pablo and Nikki are growing as individuals, and growing as a couple."
Couples Therapy airs Wednesdays at 9 p.m. ET on VH1.