Background
Study objectives
Methods/design
Study population
Inclusion and exclusion criteria
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Tinnitus type: chronic, subjective, non-pulsatile tinnitus
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Duration of tinnitus = more than 3 months
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Minimum age of the patient is 18 years old – maximum age is 75 years old
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Tinnitus Functional Index (TFI) score ≥ 25 to < 90
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Stable use of medication during therapy
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HADS – score: anxiety and depression subscores > 15
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HQ – score > 40
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Objective, pulsatile tinnitus
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Active middle-ear pathology
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Neurological and psychiatric co-morbidity for which acute psychotherapy is ongoing
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Psychosis, schizophrenia, epilepsy
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Pregnancy
Study protocol
Tinnitus Retraining Therapy
Cognitive behavioral therapy
Phase number | Treatment outline |
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Phase 1 | Educating the patient about the auditory system (brief, only if necessary after TRT sessions) |
Phase 2 | Introduction of CBT and assess the motivation and commitment towards the therapy |
Phase 3 | Help identify thoughts, emotions and behavior in response to sound |
Phase 4 | Help identify negative automatic thoughts and core belief |
Phase 5 | Education about common errors of judgment and distortions in thoughts |
Phase 6 | Challenging unhelpful thoughts and creating counterstatements |
Phase 7 | Empirical demonstration: experiencing the consequence of helpful thoughts |
Phase 8 | Behavioral desensitization and graded exposure |
Eye Movement Desensitization and Reprocessing
Phase Number | ||
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Phase 1 | Client history | Negative thoughts, feelings, sensations and experiences associated with the complaints will be identified |
Phase 2 | Preparation phase | State stability of the client Secure a “stop” sign Installation of the calm/safe place |
Phase 3 | Assessment phase | Target issue, memory, event, or symptom Target image Negative cognition: NC Positive cognition: PC VoC (Validity of Cognition) Emotions SUDs (Subjective Units of Distress) Location of bodily sensation |
Phase 4 | Desensitization phase | “Bring the target image and negative cognition to mind, notice where you are feeling it in your body” Set of bilateral stimuli (BLS) as fast as the client can tolerate After a set: “What do you get now?” “What are you noticing?” If client reports new material: “Go with that”. |
Phase 5 | Installation phase | “Do the words PC still fit, or would another positive statement be more suitable?” Check VoC: “Think about the original incident and the words PC. How true do they feel now (1–7)?” “Bring the target image and positive cognition together in your mind.” Completion of sets of BLS until no change |
Phase 6 | Body scan | The client will be asked to mentally scan the entire body and report to the therapist what they can feel |
Phase 7 | Closure | The therapist will end the session by checking if the client feels calm. Gain of the session and reactions that can appear after the session will be discussed |
Phase 8 | Reevaluation | The client gives an assessment of the results achieved in the follow-up session |