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disinhibition, distance delivery system, distance therapeutic alliance, distance treatment, nonprofessional therapist, self-disclosure, therapeutic alliance, therapist attributes, visual anonymity, wait times



  1. Lingley-Pottie, Patricia BNRN, CCRC
  2. McGrath, Patrick J. OC, PhD, FRSC


Access barriers to services result in extensive wait times. Distance delivery systems with no face-to-face contact are not yet widely accepted because of uncertainty about whether therapeutic alliance can exist. In this study, 131 participants completed a questionnaire designed to explore their distance treatment experience. The majority described positive comments about the relationship formed with their telephone coach including the strength/quality, coach attributes, and the inapprehension to disclose information to the coach. Moreover, 97% reported preference for distance treatment. Acceptance and integration of evidence-based distance delivery systems are a promising approach to primary healthcare reform.