As someone who has been present in many a couples therapy session, to include both sides of the couch, I can say this is one of the most realistic portrayals of on-the-screen therapy I have ever seen. It's a good look at what cognitive behavioral therapy looks like.

Aside from the therapy perspective? Convincing acting by all and it's a hugely funny and really touching movie. I laughed til I cried and cried til I laughed. Have tissues in hand when you choose your seat. Especially if you suspect you'll see aspects of your own marital bogged-down-ness.
Hope Springs is not the most well directed movie. It's got a few slow points and the timing is awkward in several scenes and the dialog is a little weak here and there. But overall I loved every minute of it.
It was also a great movie going experience thanks to the fact that Sam and I were two of the youngest people in the mostly packed audience. It was fun to listen to the loud bursts of laughter, the type which says, Yup. That's exactly how it is in my marriage. One guy in particular was doing a little too much relating when Streep's character fessed up that she didn't like oral sex. When Carell asked whether she was referring to giving or receiving, she stammers, Uhhh..... Huh?!? This is a woman who needs June Cleaver to teach her a thing or two.
Which leads to one of my not very important on a movie choice level but important on a female point of view level. I speak of issues raised by Streep's character but not followed up on by the therapist or elsewhere. The perspective portrayed where the woman seemed most motivated and willing to change her behavior and the man less so. Need bedroom sparks? Woman: get to it. The part about doing more for the woman to keep her interested? (Which is a number one issue in my office?) More or less hopped over by the male director. For example, we see Streep doing the Monica on a banana. Do we see Jones playing tongue-sie with a taco? No, we do not.
Oh well. It's a very good start to a very necessary dialog for older couples who want to keep sex alive. And great, all around entertainment for people who want to see a relatable married couple in a funny, poignant film.