The authors investigated the number of sessions necessary for college counseling center clients of different levels of severity of distress at intake to achieve clinically significant change (CS) in therapy. The Outcome Questionnaire-45 (M. J. Lambert, N. B. Hansen, et al., 1996) was used to categorize 914 clients by severity of distress. Analyses of outcome indicated that clients with less and more severe distress needed 14 and 20 sessions, respectively, for 50% in each group to achieve CS. Implications are discussed. (Contains 2 tables.)