Treatment data from a university counseling center (UCC) that utilized the Outcome Questionnaire-45.2 (OQ-45; M. J. Lambert et al., 2004), a self-report general clinical symptom measure, was compared against treatment efficacy benchmarks from clinical trials of adult major depression that utilized similar measures. Statistical analyses suggested that the treatment effect size estimate obtained at this counseling center with clients whose level of psychological distress was above the OQ-45 clinical cutoff score was similar to treatment efficacy observed in clinical trials. Analyses on OQ-45 items suggested that clients elevated on 3 items indicating problematic substance use resulted in poorer treatment outcomes. In addition, clients who reported their relational status as separated or divorced had poorer outcomes than did those who reported being partnered or married, and clients reporting intimacy issues resulted in greater numbers of sessions. Although differential treatment effect due to training level was found where interns and other trainees had better pre-post outcome than did staff, interpretation of this result requires great caution because clients perceived to have complicated issues are actively reassigned to staff. More effectiveness investigations at UCCs are warranted. (Contains 2 footnotes and 4 tables.)