The Psychological Management of Tinnitus: Comparison of a Combined Cognitive Educational Program, Education Alone and a Waiting-List Control

Abstract

Sixty subjects with chronic tinnitus were randomly allocated to one of three experimental conditions: (1) cognitive coping skills training (attention diversion, imagery training and thought management skills) combined with education. (2) education-only, or (3) waiting-list control. The two treatment groups improved significantly more than the waiting-list control on measures of frequency of use of coping strategies, benefits derived from the use of coping strategies, irrational beliefs and knowledge about tinnitus. Subjects who received the combined cognitive/education intervention demonstrated significantly greater reductions in distress and handicaps associated with tinnitus, and engagement in dysfunctional cognitions, than the subjects who received education alone. No significant effects were obtained on measures of depression, locus of control, or on daily ratings of subjective loudness, noticeability or bothersomeness of the tinnitus. At the 12-month follow-up, the differential treatment effects had dissipated. Although the treatment resulted in statistically significant effects, the size of the clinical effects is rather modest. Implications for the further development of treatment techniques are discussed.