Cognitive Behavioral Therapy and Tinnitus
Cima et al (2014) report that cognitive behavioral therapy (CBT) is the most evidence-based treatment option (so far) with regard to managing the tinnitus patient. In their report, they note that 15-21 percent of the adult population perceives tinnitus and some 3 to 5 percent of the population reports their tinnitus is bothersome and incapacitating. Cima et al note that evidence suggests severe tinnitus distress may come from “cognitive misinterpretations, negative emotional reactivity, and dysfunctional attentional processes,” which may facilitate dysfunctional tinnitus habituation. Therefore, they suggest treatments for tinnitus often include management of the negative reactions to the perceived tinnitus. Further, researchers and clinicians appear to agree the larger part of tinnitus suffering is associated with negative psychological reactions to tinnitus and these negative psychological reactions need to be addressed properly to effectively manage tinnitus.
Despite variations and options in day-to-day CBT protocols (such as number of sessions, private versus group sessions, total hours spent in CBT, face-to-face versus Internet protocols) the authors report “a common ground of therapeutic elements” has been established and was determined to be robust enough to guide clinical practice.” Indeed, the multiple CBT approaches “share the premise that psychological distress and resulting problems are based in malfunctioning information processing mechanism…” and they state “CBT is an integrative and pragmatic treatment approach aimed at modifying dysfunctional behaviors and beliefs in order to reduce symptoms, increase daily life functioning, and ultimately recover from the disorder….”
Cima et al report CBT has been used to effectively treat tinnitus for decades and CBT has been shown to decrease tinnitus distress, anxiety and annoyance and importantly, CBT does improve daily life functioning. They report “a general CBT-based approach seems to be the most successful in tackling distress as a result of tinnitus and increasing daily life functioning of patients.” Further, they note improvements secondary to CBT remain stable for (up to) 15 years. Finally they report “Based on the evidence…we suggest that a CBT-based approach, whether in groups or individually, is the most evidence-based choice for effectively relieving tinnitus complaints so far….”
For More Information, References, and Recommendations
Cima RFF, Andersson G, Schmidt CJ, Henry JA. (2014) Cognitve-Beahvioral Treatments for Tinnitus – A Review of the Literature. Journal of the American Academy of Audiology (JAAA) 25:29-61.