The onset of the COVID-19 pandemic during the spring of 2020 necessitated a sudden and national transition from in-person to telehealth mental health services. Burgeoning literature has supported the use of telehealth services generally, though there is little research related to its use among graduate-level trainees. The present study utilized data collected from a university counseling training center to compare client outcomes, namely ratings of depression and anxiety, between in-person (pre-pandemic; n = 86) and telehealth (intra-pandemic; n = 102) groups. Additionally, I examined treatment format (in-person vs. telehealth) as moderator of the association between client-reported working alliance and client-reported outcomes. Results showed a significant and negative effect of the working alliance on symptoms of depression and anxiety regardless treatment format. Implications for research and practice are discussed.