CBT for tinnitus - how does it work? The Oto Guide 2020

Fatema M Dawoodbhoy
Oto Health Intern | 5th Year Medical Student
December 2, 2020

Welcome back to the Oto blog! Today, we are going to dive deeper into cognitive behavioural therapy (shortened to CBT) for tinnitus and how it can help. In the 2nd blog, I took you through all the various treatments available for tinnitus. Today we’re going to go into a little more detail into how it works.

Although there is no cure for tinnitus, we know that some treatments can be effective. These treatments can be split into 2 categories:

  1. Those that aim to reduce the perception of tinnitus
  2. Those that teach you how to respond to your tinnitus and the effect it has on your life

CBT falls into the second category. 

What is CBT?

CBT is a type of phychical therapy that was originally applied to depression, but its rationale has been validated in its uses for insomnia, chronic pain and more recently tinnitus. CBT works on the basis of challenging any negative and unrealistic thoughts or beliefs you form, which can lead to destructive actions, and mould them into more positive and happy cognitions. In tinnitus, CBT specifically pays specific attention to the distress and impediment the tinnitus can induce in your life and aids in changing these negative thoughts into more constructive and desirable thoughts. CBT merges different therapy techniques such as relaxation, image modification and discussion of your thoughts. 

CBT for tinnitus - how does it work?

CBT aims to address the reaction you have to your tinnitus. As we know, tinnitus is a condition that is usually with us for life. Because it is so intrusive, it commonly results in the formation of negative thoughts. CBT can’t rid you of the perception of sound, but it can definitely help you reduce the impact of tinnitus on your life. CBT aims to help you by halting the negative thoughts we associate with tinnitus. This allows you to face them and understand how they impact your life. This therapy method can allow you to restore the normal function in your life despite the presence of your tinnitus, and eventually habituating to the sound. 

CBT Sessions 

CBT is normally offered in individual sessions but can sometimes be offered as group therapy. You will see your therapist once a week for a period of weeks, talking through the different aspects of your tinnitus and subsequent thoughts you have regarding it. CBT is not stand alone, and needs to be practised further at home and on your own time. In the session, your therapist will equip you with the tools and techniques needed to replace negative thoughts for positive thoughts, but these tools and techniques need to be further applied to your life on a day to day basis. CBT works as a way to change the way you live with tinnitus and become more accepting of this symptom. 

CBT for tinnitus in a formal setting with a specialist
CBT for tinnitus in a formal setting with a specialist


What does the science say about CBT for tinnitus?

A huge review of the scientific evidence carried out in 2010 (undertaken by a charitable organisation called Cochrane formed to organise medical research findings) concluded that CBT results in a reduction in the impact of tinnitus, and improvement in the quality of life. Even though more studies might be beneficial, there has now been enough scientific evidence analysing the effectiveness of CBT to establish it as the most effective and safe treatments for tinnitus. NICE, the National Institute for Health and Care Excellence, recommends CBT as the first-line treatment for tinnitus over other therapies and medications. 

CBT for tinnitus on the NHS

Generally in the NHS, you would first present to the GP about your tinnitus. The GP usually will offer advice if the cause behind the tinnitus is manageable. If specialist care is needed, the GP will refer you to an ENT specialist to assess your tinnitus and develop a management plan. CBT needs to be led by a trained specialist, either a psychologist or specialist audiologist. 

Up until now, you might have to wait for months before being able to access CBT on the NHS. However, with Oto’s CBT for tinnitus programme you can work through a specially curated tinnitus therapy programme from the comfort of your own home. 

Oto’s CBT for tinnitus programme

Oto is an app for tinnitus that brings together all the effective therapies into a progressive programme of CBT, targeted mindfulness, relaxation therapy and education. Not only does Oto provide science-based therapy to better manage the tinnitus but it also offers mindfulness programmes specifically targeted at reducing stress and anxiety linked to worsening tinnitus. 

Oto also provides access to a collection of specially curated masks that you can use to help relax, sleep, or just provide some respite from your tinnitus. Oto also allows you to track the impact your tinnitus is having on your life with a symptom log. You’ll be able to see how your tinnitus is affecting all aspects of your life, from sleep to mood or concentration. 

The Oto team consists of doctors, audiologists, therapists, voice artists, sound engineers and researchers, and has decades of experience in helping people with tinnitus and insight from all walks of life. 

The beta of Oto is currently completely free to download and test. You can sign up today. 

The Oto app brings together all the therapies known to be effective in tinnitus
The Oto app brings together all the therapies known to be effective in tinnitus


Bibliography

1.Cochrane. Cognitive behavioural therapy for adults with tinnitus. [Online] www.cochrane.org. Available from: https://www.cochrane.org/CD012614/ENT_cognitive-behavioural-therapy-adults-tinnitus

2.Dr. Bruce Hubbard. How CBT Works. [Online] CBT for Tinnitus. Available from: https://www.cbtfortinnitus.com/how-cbt-works [Accessed: 15th November 2020]

3.Jun HJ, Park MK. Cognitive Behavioral Therapy for Tinnitus: Evidence and Efficacy. Korean Journal of Audiology. [Online] 2013;17(3): 101. Available from: doi:10.7874/kja.2013.17.3.101

4.British Tinnitus Association. Tinnitus and cognitive behavioural therapy (CBT). [Online] British Tinnitus Association. Available from: https://www.tinnitus.org.uk/tinnitus-and-cognitive-behavioural-therapy-cbt [Accessed: 28th January 2020]

5.NICE. National Institute for Health and Care Excellence Final Tinnitus: assessment and management [L] Evidence review for psychological therapies NICE guideline NG155 This evidence review was developed by the National Guideline Centre. [Online] 2020 [Accessed: 15th November 2020]. Available from: https://www.nice.org.uk/guidance/ng155/evidence/l-psychological-therapies-pdf-255229407253 [Accessed: 15th November 2020]

6.Oto. Tinnitus Treatments: The Oto Health Guide 2020. [Online] www.otohealth.ai. Available from: https://www.otohealth.ai/post/tinnitus-treatments-the-oto-health-guide-2020

7.Oto. Tinnitus treatment on the NHS: what can the NHS offer you? The Oto Guide 2020. [Online] www.otohealth.ai. Available from: https://www.otohealth.ai/post/tinnitus-treatment-on-the-nhs-what-can-the-nhs-offer-you-the-oto-guide-2020

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