"Don't Look At Me If You're Looking For Perfection"

So, how does one improve on near perfection?

Well, if we're talking about "Under Pressure", the simple answer is this - give us one more scene with Alex and Dr. Clark.  And, maybe a do-over on the birthday party after Alex hugs Claire.

But, to do that and fit it into the allotted 21-22 minutes, we need to replace another part of that episode.  And the part I'd replace is the double date story with Luke and Manny and Zoe and Piper.  Now I'm not saying get rid of the story altogether, but I'll get to that in a moment.

Here's how I'd re-write things to give Alex more time with her story:

1) The double date story gets moved back a week (into "Three Dinners"), giving us a fourth story that week (that also balances out things a bit between the two episodes).  Also, the title of that episode would now become "Four Dinners" (yes, that does nothing to get Alex into that episode, but we can't fix everything¹).

2) Luke now can join Haley helping Mitch deal with Asher.

3) Manny can help Cam out (remember he was the kicker on the football team at the time) at the school open house.

4) (optional)  Since Luke would now appear in one more episode than originally happened, if you'd like to balance that (it doesn't really matter to me), he can be left out of an episode where he doesn't have that big a role (probably one of the earlier episodes, like "The Help" or "Closet Con 13").

And now we have more time for Alex - maybe we could've have heard more about her other anxieties (e.g. the lack of a boyfriend, or any friend for that matter, or more about her role in the Dunphy household).   I'd put this scene just before the second commercial break, after the dodgeball incident.
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¹ One thing I would fix about that episode: Ditch the snarky comments between Gloria and Manny as Jay and Shorty were saying their final farewells (for the moment) - that all but ruined what was a scene almost as emotional as the above mentioned scene with Alex and Claire at the therapists' office.