When driven correctly the 48re is a very good and dependable transmission. My '05 had 475,xxx miles on the factory build before the transmission was busted by one of my drivers. The '06 has about 575,xxx miles on the original transmission and is still going strong. Both trucks have hauled or towed for much of their existence.
When used in "tow/haul" mode the 48re acts more like a 5 speed transmission than a 4 speed because of the timing of the torque convertor lock-up after being in 3rd gear for a bit. This fact really helps the engine move the load without having to wind the engine over 2000 or so rpm's. The braking effect while slowing in "tow/haul" mode is also very helpful in providing control without wearing out the brakes.
Two things to NOT do with a 48re: 1. Do not engage "tow/haul" at speed. When already in overdrive with the torque convertor locked before engaging "t/h" the TC will unlock until you "reset" by slowing down and allowing the computer to lock the TC. It's best to engage "t/h" before moving the truck.
2. Do not allow the engine to downshift while the cruise control is engaged with "t/h" engaged. The engineers did not do their homework here. When in OD and TC locked with cruise engaged, the transmission will unlock the TC and drop to 3rd gear when going up decent grades with a load. The engine will rev very high which prevents the TC from locking. I'm guessing this is how the trans in my '05 was killed, too much heat from TC slippage.
Do not be afraid of the 48re, just treat it with respect. I would recommend the 4. 10 ratio if towing heavy with the 48re.
Having said all that, I am also partial to my NV5600. Just overfill it with 7 total quarts of fluid (I prefer Royal Purple Synchro Max) and change oil every 100,000 miles. When rebuilding it take it to Standard Transmission in Fort Worth and have them install the Power Lube package which literally uses 1st gear to pump oil to the rear mainshaft bearing. I really like the 3. 74 ratio with this transmission.
May your work for our Lord be blessed!
Godspeed,
Trent