Tinnitus E-Programme Part One
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Tinnitus E-Programme

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Information about the Tinnitus E-Programme for Professionals:

  • Audiologists
  • Other professionals whose field includes tinnitus

The TEP Part 1 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

It is an online THERAPIST SUPPORTED intervention for the management of tinnitus distress. 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 (Part 1 only) 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
  • 2 – 4 weeks after completing Module 5
  • Repeat measures: THI and TFI (and others where I have recommended e.g. HSQ for hyperacusis, anxiety questionnaire etc)
  • Either end of intervention or move on to the Tinnitus E-Programme Part 2 (in-depth CBT and ACT)

Specific Interest Subjects Section

In addition to the 6 modules, there is a section called “Specific Interest Subjects”. Currently they are:
  • Sleep (Available upon enrolment)
  • De-fusion – how to “de-fuse feelings using an ACT method (Acceptance & Commitment Therapy) – available after 3 weeks to coincide with Module 4
  • Currently being drafted: Mindfulness Exercises (To be available upon enrolment)

Tinnitus E-Programme © 2009-2019
by Debbie Featherstone MSc
Hearing Therapist & Psychotherapist
Tinnitus Project
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