Are perceived increases in symptom severity in college counseling center clients real or imagined? Counseling center staff, retrospectively, reported that client problems are more severe now than in the past. Yet studies examining client distress levels at intake have found no significant increases. This study examined counseling center client problems across 13 years from the perspective of the treating therapist at the time of case closure. Increases were found for 14 of 19 client problem areas, whereas other areas retained stable levels, and 2 problem areas had a quadratic trend over time. These changes directly affect counseling service practices.