Florida Rule 64B4-10.003: The 2-Year Rule and Patient Relationships for LCSWs

A significant regulatory change is now in effect for Florida-licensed clinical social workers (LCSWs), and it directly affects how professional relationships are evaluated after termination. How these relationships are terminated are particularly important because the Department of Health will review social media communication when investigating the relationship.

As of March 2, 2026, Rule 64B4-10.003(2), Florida Administrative Code, has been amended to remove the long-standing “2-year rule” and replace it with a more reasonable and just case-by-case standard.

For LCSWs, this is an important shift that affects both compliance and risk exposure.

What Was the “2-Year Rule”?

Under the prior version of Rule 64B4-10.003(2), the psychotherapist-client relationship was automatically considered to continue for two years after the last professional contact or termination of the relationship.

This created what is known as an irrebuttable presumption, meaning:

• The relationship was legally assumed to continue for 2 years
• No evidence could be introduced to prove otherwise

Even in situations where:

• A client formally terminated services
• All appointments were cancelled
• Care was transferred to another provider
• The client relocated

The rule still treated the professional relationship as ongoing.

This framework created tension with established case law and lacked support in clinical or professional literature related to LCSWs.

What’s Changed?

The updated rule eliminates the automatic two-year presumption and replaces it with a fact-specific analysis.

Now, whether a professional relationship has ended will be determined based on the circumstances of each case.

The revised rule introduces several key factors, including:

• Whether formal termination procedures were followed
• Transfer of care to another psychotherapist
• Length of the professional relationship
• The nature and depth of confidential disclosures
• The client’s presenting issues
• The degree of emotional dependence

This approach provides a more balanced and realistic framework for evaluating when a professional relationship has actually ended. The Department will look at texts, emails, WhatsApp, Facebook and other social media to argue that the relationship continues.  Be cautious about using social media with ex-patients.

Why This Matters for LCSWs

This change significantly alters how regulatory bodies may evaluate allegations involving former clients.

Rather than applying a rigid 2-year rule, the Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling (Board) will now assess using the factors listed above.

Importantly, paragraph (4) of the rule continues to govern conduct involving former clients, focusing on whether any interaction was:

• Exploitative
• Abusive
• Detrimental to the client’s welfare
• Based on trust or influence developed during the professional relationship

Alignment with Other Health Care Professions

The revised rule brings LCSW regulation more in line with standards applied to other psychiatric and psychological providers.

It reflects a broader regulatory trend toward:

• Context-driven evaluations
• Recognition of professional judgment
• Greater alignment with legal precedent

A More Balanced Legal Standard

The updated rule also addresses concerns related to constitutional privacy rights by avoiding an overly broad and inflexible presumption.  Florida has a strong constitutional right to privacy, including concerning one’s sexual relationships, that other states do not.  The 2-year irrebuttable presumption has been removed in the Florida rule but does exist in other states.

By allowing for a case-by-case analysis, the rule creates a more equitable framework for both:

• Licensed professionals
• Former clients

What LCSWs Should Do Now

With this change in place, LCSWs should take a closer look at their:

• Termination procedures
• Documentation practices
• Transition of care protocols

Clear, well-documented termination processes will play a critical role in demonstrating when a professional relationship has ended. However, if the termination paperwork was prepared to help induce sexual contact with an ex-client, the licensee can be guilty of a crime and jeopardize their license.  LCSWs should also seek help from a qualified lawyer whenever advice is needed on relationships concerning ex-clients.

A Note on the Rule Change

This amendment was initiated through a formal petition filed by John E. Terrel, and the Board acted to adopt a more practical and legally consistent standard.