Is Cognitive Behavioral Therapy Effective for Tinnitus?

BACKGROUND

Tinnitus, the perception of sound in the absence of an external stimulus, affects 15%– 20% of the adult population, with 10%–20% of these individuals reporting significant functional impairment. Despite its high prevalence and associated morbidity, few effective treatments exist for tinnitus. Recently, cognitive behavioral therapy (CBT) has emerged as a promising approach for managing tinnitus. Unlike other treatments that attempt to diminish or mask the tinnitus percept itself, CBT instead explores the relationship between an individual’s negative thoughts, feelings, and behaviors connected to the experience of tinnitus. Recent studies on CBT and tinnitus have yielded promising results, and the American Academy of Otolaryngology–Head and Neck Surgery now recommends offering CBT to patients with persistent, bothersome tinnitus as part of their official Clinical Practice Guidelines. However, concerns have been raised over several issues, including comparative efficacy with other treatments, response variability, access to care, and cost-effectiveness.

BEST PRACTICE

Cognitive behavioral therapy is an effective treatment option for individuals with bothersome tinnitus, particularly for those with high levels of tinnitus distress and anxiety. In addition to individualized, in-person CBT, both group- and internet-based options can be equally successful, while simultaneously improving access and increasing cost-effectiveness. Future prospective trials evaluating predictors of treatment success and the durability of therapeutic responses are needed