Understanding Tinnitus & Sound Sensitivities
Frequently asked questions
Is There a Cure for Tinnitus?
At this time, there is no cure for tinnitus. But there is definitely much that can be done to reduce the perception of tinnitus and manage the negative effects it often has on your life. Audiologists certified by the Tinnitus Practitioners Association are able to determine the method that is appropriate for each individual
A following is a brief description of these methods:
Cognitive Behavioral Therapy (CBT)
Cognitive Therapy is described by Wilson and Henry (1993) as “identification of dysfunctional beliefs and recurrent, persistent negative thoughts which occur in reaction to significant life events or daily stressors”. People are taught methods to challenge those thoughts, and to substitute their catastrophic, unrealistic thoughts with more constructive ones, an approach known as cognitive restructuring. Another form of cognitive therapy aims to assist the person to control the direction of attention through imagery, re-direction of attention, or relaxation.
Cognitive Habituation Tinnitus Therapy (CHATT)
Audiologists are uniquely qualified to provide tinnitus care using counseling and sound therapy. CHATT was developed by the Directors of the TPA using an eclectic approach to individualized care as determined by the practitioner. The program encourages a systematic subjective and objective evaluation process, instructional and cognitive counseling and recommendation of sound therapy options which are specific to the individual needs of the patient.
Masking has successfully been used in treatment programs around the world since the first wearable devices were created to mimic the sound of rushing water (DeWeese and Vernon, 1975). Because tinnitus is a perception of sound, masking relies on the patient’s report of the ability of noise to reduce or eliminate their perception of tinnitus. The search to discover what creates this relief has led to numerous developments in the evaluation of tinnitus, methods of management and devices to provide relief.
A Multidisciplinary approach to management of the tinnitus and hyperacusis patient as described by Ruth and Hamill-Ruth (2001) combines audiology, otology, and pain management. Each member of the multidisciplinary team provides evaluations and recommendations. Tinnitus and hyperacusis have a number of characteristics that are similar to a variety of chronic pain syndromes such as anxiety, depression, sleep disturbance, therefore, an evaluation of head-neck complaints and the patient’s medical regimen are often vital to overall success.
Neuromonics Tinnitus Treatment
Neuromonics Tinnitus Treatment was created by Paul Davis, PhD. A small device uses a customized auditory stimulus combined with specific music and delivered according to a coordinated program. This treatment is designed to interact, interrupt, and desensitize tinnitus disturbance for long term benefit.
Progressive Tinnitus Intervention
The Department of Veterans Affairs (VA) National Center for Rehabilitative Auditory Research in Portland, OR addresses the need for tinnitus management in the VA by outlining a five level “progressive intervention” approach that would provide a systematic framework for treatment. Screening, group education, evaluation, and different levels of treatment are used to minimize the impact of tinnitus on the patient’s life as efficiently as possible.
Tinnitus Activities Treatment
Tinnitus Activities Treatment includes counseling of the whole person, and considers individual differences and needs. Four areas of consideration are: thoughts and emotions, hearing and communication, sleep, and concentration. Typically, a Partial Masking Sound Therapy is used with noise or music set to the lowest level that provides relief. A picture-based approach facilitates engagement of the patient, and provides thorough and structures counseling. The patient is engaged by including homework and activities to demonstrate understanding and facilitate progress.
Tinnitus Retraining Therapy (TRT)
TRT is based on the “Neurophysiological Model of Tinnitus” developed by Pawel Jastreboff (1990). Utilizing the principals of neuroscience he recognized that the properties of the central nervous system have clinical implications and play an important part in the management of tinnitus. The brain exhibits a high level of plasticity and it is possible to habituate to any sensory signal, if it does not have negative implications, therefore, it is necessary to interfere with tinnitus-related neuronal activity above the tinnitus source to achieve habituation. The clinical goal is to remove the perception of tinnitus from the patient’s consciousness using directive counseling and low level sound therapy.