CBT for Tinnitus E-Programme

Tinnitus E-Programme

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ABOUT THE CBT for TINNITUS E-PROGRAMME (TEP)
Information about the 6 and 12 Module Tinnitus E-Programme for Professionals:

  • Audiologists
  • Other professionals whose field includes tinnitus

The 6 Module CBT for Tinnitus E-Programme
Appropriate for those with up moderate tinnitus distress (THI category 3), the Tinnitus E-Programme is a 6 module, 4 stage/stepped intervention using a CBT (Cognitive Behavioural Therapy) approach. Pre-intervention measures include the THI (Tinnitus Handicap Inventory), TFI (Tinnitus Functional Index) and anxiety measure. Additional measures may be used at the recommendation of the therapist, for example, the Hearing Sensitivity Questionnaire when hyperacusis is present


An online THERAPIST SUPPORTED intervention for the management of tinnitus distress and includes up to two 1-1 meetings using Zoom (video and audio) and regular email support. Each stage/step comprises the following:

Modules 1 and 2 - Stage 1:
  • Understanding the mechanism of tinnitus using a psycho-neurobiological model including the inter-related effects of the triune brain and the autonomic nervous system (ANS)
  • Using a regular (minimum 3 x daily although I recommend minimum 6 x daily in most cases due to severity of symptoms) combined breathing and focus/attention exercise; each time takes between 2-3 minutes – to impact the ANS. This exercise is used throughout the whole TEP
  • Understanding that changing how we are is a process – I use the Prochaska & diClemente model of Stages of Change; there is also a section about the neuroscience behind change
  • Introducing “liminal thinking”: as we go through that change process, how we are breaking the boundary of “what we think we know” – includes a video
  • Learning about the effect of stress/arousal – I use Peter Nixon’s model based on the Yerkes Dodson curve. The TEP User identifies where they have been and where they are now on that curve
  • There is also a newer model of the ANS called the Autonomic Ladder (Stephen Porges & Deb Dana). This is a recent addition to both the TEP and my clinic work
  • Module 2: first of 4 guided relaxation recordings

Module 3 – Stage 2
  • Link “tinnitus perception” with Ramsdell’s model of hearing
  • Link “significance of meaning” with “significance of sound” i.e. when we have an emotional reaction to what we think/believe about tinnitus - or any experience - it causes symptoms/distress
  • Second of 4 guided relaxation recordings

Modules 4 and 5 – Stage 3
  • Understanding what negative thoughts are and what they do; how they lead to the “tension cycle”
  • Introduction to “cognitive distortions”: use Tinnitus Cognitions Questionnaire (TCQ): It helps to identify “how often you find yourself thinking negative thoughts about tinnitus and how strongly they are affecting you”
  • Begin to use Thought Records to further identify negative automatic thoughts (NATs). These are completed online in the TEP website
  • Neuroscience research in tinnitus – includes video recordings
  • Third and fourth of 4 guided relaxation recordings

Module 6 – Stage 4
  • Finalising the intervention
  • Recommended during week 10 (10 weeks post enrolment)
  • Repeat measures: THI and TFI (and others where I have recommended e.g. HSQ for hyperacusis, anxiety questionnaire etc)

Specific Interest Subjects Section

In addition to the 6 modules, there is a section called “Specific Interest Subjects”. Currently they are:
  • Sleep - based on the work of Professors Colin Espie & Matthew Walker (Available upon enrolment)

The 12 Module CBT for Tinnitus E-Programme

For those with severe tinnitus distress (TFI score 48%+), a necessarily slower pace than the shorter 6 module course. Includes a 6-week course in Autogenic Relaxation and addressing "thinking errors" (cognitive distortions) at a deeper level. Course details

Tinnitus E-Programme © 2009-2020
by Debbie Featherstone MSc
Hearing Therapist & Psychotherapist
Tinnitus Project
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