Warning! The following post contains spoilers.
Tricia had been a patient of Adrienne Hale. Adrienne used her to drug EJ and get him to her house. Adrienne blackmailed Patricia because she had discovered that Patricia had killed her fiance and friends.
Adrienne killed EJ and buried him in the hidden space on her office floor. Tricia was worried about her part in EJ's death, so she killed Dr. Hale.
Ethan's mother was also a patient of Dr. Hale's. She was the patient who thought that her son was out to kill her. And she was right to be worried. Ethan did kill his mother.
Tricia and Ethan killed Luke together. And then lived happily ever after.
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