Cognitive behavioral treatment of tinnitus: psychological aspects

An overview of tinnitus (ringing or buzzing in the ears) and its psychological effects is presented in this paper. The application of cognitive behavioral therapy (CBT) with tinnitus patients is reviewed. Several studies have confirmed an association between psychological factors, such as anxiety and depression, and severe tinnitus. Moreover, preliminary reports suggest that tinnitus patients sometimes suffer from mental illness, in particular major depression. Assessment strategies used in CBT for tinnitus involve structured interviews, daily diary ratings and validated self-report questionnaires. The treatment includes applied relaxation, imagery and distraction techniques, advice regarding environmental sounds, management of sleep, and cognitive restructuring of thoughts and beliefs associated with tinnitus. The treatment ends with relapse prevention to prepare for fluctuations in distress caused by tinnitus. The effect of psychological treatment according to CBT principles is also reviewed. It is concluded that CBT shows promising results as a treatment of tinnitus-related distress.