As we saw in the first trailer, it looks like Joel is going to therapy in season two. Schitt’s Creek’s Catherine O’Hara is playing Joel’s therapist, and we see her get a bit snippy with Pedro Pascal’s “sad dad.” She puts on a timer and asks if he “wants to start, or what?” I imagine Joel is not too thrilled at the idea of going to a therapist, and might be coming into these sessions rather guarded, so O’Hara’s character is likely unhappy with his dismissive attitude.
This scene does appear to be a kind of stand-in for the opening of The Last of Us Part II in which Joel confesses to his brother Tommy that he murdered dozens of Firefly radicals who were planning to kill Ellie to create a vaccine for the cordyceps fungus ruining the world. Does doctor/patient confidentiality apply to something of that magnitude?