Background - The demands of academic life are considered to be increasingly stressful for students in higher education, but there is limited research about the extent to which those attending student counselling services experience difficulties relating to academic issues and how effective counselling is for them. Aim - The study aimed to evaluate the reliable and clinically significant change for students with self-reported academic issues. Reliable change occurs when a change in the outcome being measured is not attributable to error, while clinically significant change occurs when a person moves from a clinical population to a healthy population after an intervention, in this case counselling. Methodology - Pre-existing data from 129 university students who had attended a student counselling service were analysed to determine levels of reliable change and clinically significant change. These data related to psychological status before and after counselling based on CORE-OM total scores; self-report of the impact of counselling on academic issues; and demographic variables. Findings - In total, 117 (92%) of students reported experiencing academic issues to some extent. Counselling was found to result in reliable change for 67% and clinically significant change for 40% of those students reporting academic issues. Implications - The results of the study suggest that, even where academic reasons are not the primary cause of referral to student counselling services, a significant number of students will also experience difficulties in these areas. Counselling was, however, shown to result in reliable and clinically significant change in a high percentage of those experiencing these additional difficulties.