Today’s television landscape would look like an alien planet to visitors from 2002. Cable had only begun to hit its stride with original programming, “streaming” TV had not yet taken hold, binging an entire new series in a weekend wasn’t possible. And despite the existence of hundreds of channel options, a series focusing seriously on mental health was nowhere to be found.

Then Dr. Phil McGraw came along. After several tryouts on “The Oprah Winfrey Show,” the folksy, mustached, straight talking doctor of psychology landed his own series. “Dr. Phil” premiered on Sept. 16, 2002 — and the floodgates were officially opened. Equal parts insight and heartfelt entertainment therapy, with a sprinkle of ratings-goosing sensationalism, McGraw and his team, which includes his wife, Robin, on camera and executive producer Carla Pennington behind it, kicked off with an episode focusing on stressed-out parents who yelled at their kids.

Twenty seasons later, they’ve never looked back.

“Phil offers a compass to those who are lost in their lives,” says Pennington, who has been with the show for its full run. “At the time the show launched, mental health was a dirty little secret, so he was the first clarion voice for people in crisis and letting viewers know there’s other people out there who have the same issue.”

“Dr. Phil” occupies a prime genre for first-run syndication: the advice show confessional. McGraw found success for 20 seasons — more than 3,500 episodes — by addressing everything from broken families to drug addiction, eating disorders and domestic violence. He’s not trying to save the world, just the individual, and that personal touch has kept his audiences strong. For 11 consecutive seasons, or since Winfrey signed off in 2011, “Dr. Phil” has been the No. 1 syndicated talk show, according to a CBS Media Ventures rep, and the first four weeks of his newest season (which premiered Sept. 13) have reached nearly 18 million viewers.

Such a wide reach makes him valuable property for CBS Media Ventures, which co-produces and distributes the show. “There’s no other doctor on the air with his perspective,” says president Steve LoCascio. “Phil is really different from all the other talk shows. And from a local station perspective, the lead-in for news is critically important, and he’s a really good news lead-in.”

Over the years, the show has proven nimble enough to reflect fluctuating societal changes and trends; for example, when it began airing, social media didn’t really exist and the opioid epidemic hadn’t begun to make headlines, but the series pivoted to address the effects of both on the human psyche. Then when the 2020 pandemic and quarantine hit, the show shifted to a virtual audience and focused on the effects of lockdown.

“The minute we went into lockdown [McGraw] said, ‘I’m really concerned about what is going to happen with the mental health of this country when we start to come out of this,’” recalls Pennington. “And now we’re seeing it.”

McGraw became the voice of reason for millions of audience members as the show honed in on quarantine-related anxiety and stress. “It was a shared experience so everyone can feel they’re not alone and make the conversation accessible to the masses,” she continues. “Isolation was a killer for everyone.”

He was indispensable to CBS Media Ventures, too: LoCasio recalls the company holding a town hall at which he spoke for 20 minutes and addressed employees about how to deal with quarantine-related mental situations.

“His message was spot on,” says LoCasio. “People needed that in the early stages of COVID.”

Now, the show is pivoting yet again to a post-COVID conversation even as the virus continues to affect Americans. “Dr. Phil” is working with a hybrid in-person and virtual audience, and planned topics for its 20th season include the overmedication of Americans, domestic violence, eating disorders, scams and catfishing. In addition, the show is taking a look back at some of its success stories, featuring viewers offering takeaways of what they’ve learned on the show.

“We want to focus on the change in relationships people have because of what they went through,” Pennington says. “Quite a few marriages are on the brink, the divorce rate has gone up. There are a lot of parenting stresses because everyone has spent so much time together. We started off 20 years ago doing those shows, and now we’re doing them again after having gone away from it for a while.”

There’s real satisfaction in being able to look back and see how “Dr. Phil” has changed the landscape. It seems hard to imagine that series including “Intervention” and “The Biggest Loser” would have caught fire without having McGraw’s show topics as springboards. Further, Pennington says she’s sure the show has moved the needle on discussing mental illness in America.

“It’s no longer a stigma to say, ‘My therapist said …,’” she notes, adding that it’s edifying to have early guests who’ve gone on to become productive citizens. Pennington is particularly fond of the idea of guests who’ve learned from McGraw “paying it forward.”

“After 20 years on the air, a lot has to go right,” says LoCasio. “People still have to want your message. It has to work from a ratings perspective — and to do all that after 20 years, it’s a milestone that shouldn’t be overlooked.”

Nor does it seem that McGraw has any intention of wrapping things up. There’s always going to be another problem to solve or trend to react to, and he wants to be there to help people get through some of their toughest moments.

“I don’t see Phil slowing down any time soon — and I can outrun him,” quips Pennington. “We’re going to continue to follow the trends. There are social- media influencers, kids trying to be TikTok stars dropping out of college. Is that a good idea? We like to pose questions and ask, ‘What the hell are they thinking?’ And we’re going to be saying that, saying ‘What the hell are you thinking?’ for years to come.”