TRT und Psychotherapie beim Leiden am Tinnitus

Abstract

Basic requirements and results of tinnitus retraining therapy (TRT) as well as other habituation therapies with psychotherapeutic approaches in the treatment of tinnitus are examined closely in this literature review. In German-speaking countries experts generally aim for involvement of psychotherapists beyond the classic TRT developed by Jastreboff and Hazell. On the basis of a validated diagnostic test such as the Tinnitus Questionnaire according to Hiller and Goebel (1998), such a therapy regime is more effective than the "classic" procedure. Under different treatment approaches, cognitive behavioural therapy elements have been proven to be effective-even as a component of the TRT-as well as integrated variants in psychodynamic therapies. We have to give consideration to the fact that in all studies about the selection and inclusion criteria selective test conditions were established which suggest that in each case diverse patient groups were studied. In the overall picture it becomes apparent that depending on the severity of the tinnitus and accompanying hearing problems a dysfunction-oriented and staged approach makes sense.

Evidence and evidence gaps in tinnitus therapy

“…In no case, a claim of superiority of cognitive behavioral therapy must be deducted from the cited meta-analysis of studies with very limited study design regarding its implementation in outpatient single therapy or daily clinical practice [17]. …”

“…However, the meta-analysis of Martinez-Devesa [16] for example and other studies with limited study design must not lead to the claim of superiority of “cognitive behavioral therapy” for outpatient individual therapy or in daily routine [17]. …”

Prä- und Post-Ergebnisse einer stationären neurootologisch fundierten und psychosomatischen Tinnitustherapie

“…Bei den stationär behandelten Tinnituspatienten der Autoren überwog das männliche Geschlecht, das durchschnittliche Alter mit 50,9 Jahren (SD = 12,43) entspricht anderen Untersuchungen mit stationär behandlungsbedürftigen Tinnituspatienten [6,10,19,20,22].…”

“…HinsichtlichderTinnitusbewältigung hat sich für die kognitive Verhaltenstherapie ihre Wirksamkeit -unter bestimmten Bedingungen [17,22] -evidenzgerecht nachweisen lassen, sodass sie auch Grundlage ausgearbeiteter Manuale darstellt [2,3,16]. Zusätzlich hilft aus der Erfahrung der Autoren ein psychodynamisches Verständnis v. a. bei den im Tinnitusleiden "somatisierenden" Patienten, die sich nicht auf ein manualisiertes Vorgehen -das die Akzeptanz des Ansatzes quasi zur Vorbedingung macht -"einlassen können".…”

Multiple-Frequency Matching Treatment Strategy for Tinnitus

“…After a period of stimulation, the spontaneous activity of some or all of the hair cells can be recovered, reducing spontaneous discharge of auditory nerve activity and returning auditory nerve function to normal [8] . Damage to the central nervous system's memory of tinnitus can relieve tinnitus, and it will ultimately disappear.…”