modified to suit telephone health coaching sessions and used to score the therapeutic alliance developed within participant interviews (n ¼ 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

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... subjectivity of the WAI-O-S. The modified version was determined to be feasible. Conclusions: 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.