Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a therapeutic approach with applications to Tinnitus and other conditions such as depression, anxiety, post-traumatic stress, chronic pain and other issues where the individual may have developed a negative perspective on their challenges and limiting beliefs around how they will get past these challenges.
In the Cochrane Database of Systematic Reviews 2007, Issue 1, Martinez D, Waddell, P and Theodoulou, M, looked for evidence based support for whether Cognitive Behavioral Therapy is effective in the management of patients’ suffering from tinnitus. Six clinical trials (285 participants) were included in this review. They found a significant improvement in the quality of life suggesting that CBT has a positive effect on the way in which people cope with tinnitus.
In the Cochrane Database of Systematic Reviews, 2010, was an update of the 2007 study. The objective of this review was to assess whether cognitive behavioural therapy is effective in the management of patients suffering from tinnitus. Eight trials (468 participants) are included in this review. Data analysis did not demonstrate any significant effect in the subjective loudness of tinnitus. We found, however, a significant improvement in the depression associated with tinnitus and quality of life (decrease of global tinnitus severity), suggesting that cognitive behavioural therapy has a positive effect on the way in which people cope with tinnitus.
The Otolaryngology Head and Neck Surgery 2014, Vol. 151(2S) S1–S40 © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014 published an article entitled Clinical Practice Guidelines for Tinnitus. It was and still is considered the Gold Standard for tinnitus management. CBT was reported to have evidence-based research supporting the efficacy of CBT.
CBT is a therapeutic approach that empowers the person, who for some time, perhaps years, has lost their sense of control and power over to their condition. CBT facilitates ways that people can reclaim that power in spite of their Tinnitus through the application of various self management strategies.
In order to understand Cognitive Behavioral Therapy, it is important to understand the premise behind Cognitive Theory.
Cognitive Theory:
According to Cognitive Theory, the emotions that people experience in response to an event are highly influenced by the content of their thinking.
If we think of Tinnitus as being a ‘sound event’, cognitive theory would be saying that what you tell yourself about the tinnitus, is going to highly influence the emotional consequences and behaviors toward it.
The fact that different people assign different meaning and thoughts to the tinnitus partly explains why people cope and respond differently to having tinnitus.
If we look at Tinnitus as the event, this theory is suggesting that if the content of thinking in response to the tinnitus is negative, it will directly impact the emotional distress that will be experienced.
This is where the techniques learned in Cognitive Behavioral Therapy (CBT), can plant seeds of hope for the person with Tinnitus because we always have a choice about how to respond. The person may not have a choice about whether they will have tinnitus or not, but they CAN decide the meaning they are going to give it in their life.
The principles of Cognitive Theory now allow us to look at the exciting applications of CBT in the treatment of Tinnitus.