This study compared pre-treatment distress and the changes in that distress over the course of therapy between sexual trauma clients and non-sexual trauma clients. Reasons for therapy ending were also examined. Data for this study were collected at 139 university counseling centers. Psychological distress was measured using the Counseling Center Assessment of Psychological Symptoms; presenting concerns were determined using the Clinician Index of Client Concerns; and reason for end of treatment was measured using a standardized Termination Form. MANOVA was utilized to test differences in psychological distress at the start of therapy and a MANCOVA was used to examine psychological distress over the course of therapy. Chi-square tests were used to examine if different reasons existed for why treatment ended. Clients that experienced sexual trauma presented to treatment with significantly higher levels of distress but demonstrated greater distress change. No statistical differences in reasons associated with the end of treatment.