Cognitive Behavioral Therapy (CBT) is a widely-practised psychological treatment designed to restructure the thoughts and behavior of patients who have lifestyle and emotional difficulties. Patients are asked to question their outlook on their life, and to restructure negative associations they make towards themselves, their environment or a particular ailment from which they suffer.

A large body of evidence shows that CBT is effective in anxiety and depression management. As well as the obvious benefits this produces for tinnitus sufferers, CBT can also be successful in altering the negative feelings that are evoked by someone’s tinnitus. This form of ‘cognitive restructuring’ can reduce heightened awareness of tinnitus, which in turn paves the way towards habituation.

CBT does not consist of only one form of treatment, but includes behavioral modification, environmental and situation change, relaxation, hypnotherapy and thought-controlling exercises [[i]].

A Swedish report in 2004 demonstrated that CBT delivered via emails from therapist to patient resulted in clinically significant reduction of distress as measured for 27.4% of patients.  A three-month follow-up demonstrated that the improvements had been maintained, but there was a high drop-out rate of 30% from the treatment. Although this is a cost-effective and labor-saving form of CBT, the majority did not benefit. CBT may be best administered one-to-one or in a group setting [[ii]].

A study which reviewed a large amount of clinical data on CBT, showed that there was no significant reduction in subjective tinnitus loudness or associated depression. But they did conclude that CBT significantly improved quality of life which led to positive management of tinnitus.     

Overall, although CBT may not be conclusively proven to reduce tinnitus intensity, it is generally considered as an effective means of managing the distress provoked by tinnitus. It is also believed that CBT facilitates acceptance and alleviation of negative thoughts towards the tinnitus, which improves quality of life by reducing associated fear, anxiety and depression [[iii]].