Background: The therapeutic alliance has been identified as influencing therapy outcomes. The Working Alliance Inventory has been used to measure the therapeutic alliance between therapists and clients within psychology. No validated measure of the therapeutic alliance exists within telephone health coaching sessions for weight loss.
Aim: To determine the feasibility of methods developed to measure the therapeutic alliance achieved within telephone health coaching sessions for weight loss.
Methods: The Working Alliance Inventory Observer-Rated Short Version (WAI-O-S) (12 items, 7 point Likert Scale) and corresponding manual were modified to suit telephone health coaching sessions and used to score the therapeutic alliance developed within participant interviews (n=18). Each phase of development was documented. Inter-rater reliability was measured between two raters to confirm reliability using Kappa coefficients. Discrepancies were discussed between raters.
Results: Kappa coefficients for each item ranged from 0.039 to 0.640 prior to rater discussions and 0.203 to 0.895 post rater discussions. Raters commented on the subjectivity of the WAI-O-S. The modified version was determined to be feasible.
Conclusion: The modified version of the WAI-O-S for telephone health coaching sessions for weight loss is a feasible tool for measuring the therapeutic alliance. More research may be necessary to determine further refinements.
Funding source: Illawarra Health and Medical Health Institute