Cognitive Behavioral Therapy for Tinnitus: Addressing the Controversy of Its Clinical Delivery by Audiologists

Abstract

Audiologists' role in providing care for tinnitus typically includes conducting an audiologic evaluation, fitting hearing aids when appropriate, assessing the impact of tinnitus, and facilitating use of sound to improve quality of life with tinnitus when appropriate. Cognitive behavioral therapy (CBT) is consistently judged by systematic reviews as having the strongest evidence relative to other therapies for improving quality of life with tinnitus. Because audiologists are already playing an active role in providing care for tinnitus, and the relative paucity of behavioral health providers who are experienced in implementing CBT for tinnitus, a logical question is whether audiologists can provide CBT and whether it is within their scope of practice. In this article, we present both sides of the argument as to whether audiologists can provide CBT and we make recommendations for appropriate administration of CBT for tinnitus management.

The Current State of Evidence Regarding Audiologist-Provided Cognitive Behavioural Therapy for the Management of Tinnitus: A Scoping Review

“…Notably, most of these studies excluded individuals with significant mental health problems. This may represent a viable and appropriate model of Audiologist-provided care for tinnitus, as one of the main arguments against Audiologist-provided CBT is that Audiologists are not equipped to deal with significant comorbid mental health issues [ 48 ]. Indeed, Audiologists who have been involved in delivering CBT to tinnitus patients have reported similar concerns [ 54 ].…”

Exploring the interplay of depression, sleep quality, and hearing in tinnitus-related handicap: insights from polysomnography and pure-tone audiometry

“…Most of these have sedative or mood-stabilizing effects. There is much overlap between the treatment modalities of tinnitus and depression, including drug therapy, cognitive behavioural therapy [ 47 , 48 ], tinnitus desensitization therapy, and repetitive transcranial magnetic stimulation [ 49 ]. Collaboration between psychiatrists, neurologists and otolaryngologists is important for the future treatment of both diseases.…”

An Update on Cognitive Behavioural Therapy (CBT) in the treatment of tinnitus

“…Unfortunately, this specific type of CBT provided by trained psychologists is not widely available for patients suffering from tinnitus even in the United Kingdom 6,19 . There is also controversy surrounding the quality of CBT delivered by audiologists which is still being evaluated 19…”