The office that Dr. Hill is seen sitting in has now become molded with the snowy forest that the Psycho, who at this point has been revealed to be Josh, is being dragged through by the Wendigo.
Dr. Hill tells Josh that he should should have listened to him, and because of his actions people have died. He blames the disappearance of the twins on Josh, and comments on how the game has fallen apart before questioning why he hurt his own friends, hoping that he will somehow atone for his sins.
If during the Fourth Therapy Session, the player picked that they most disliked Josh, instead of Dr. Hill asking why he hurt his friends, he will question Josh as to why he dislikes himself as much as he does. If the player picked that they most disliked Chris or Ashley, Dr. Hill will question why he despised either one of them, and that they did nothing to him.
Josh can eventually be remorseful about his actions or be unrepentant.
- When Dr. Hill berates Josh for his inexcusable behavior, if Josh apologizes for his actions, Chapter 9 will be called 'Despair' and Chapter 10 will be named 'Repentance'. On the other hand, if Josh claims that it was just a game, Chapter 9 will instead be named 'Karma' and the final chapter will be called 'Resolution'.
- Making Josh remorseful about his actions is a necessary prerequisite for his survival in the 2024 remake. He must pick "They hurt me," which then (depending on earlier made choices) unlocks the following option to say "I'm so sorry." However, note that the option for Josh to express remorse does not always appear, and it is unclear which specific decisions trigger this outcome, as the necessary decisions vary significantly and there are multiple different accounts given for how to get it.