Making use of the collaborative research between neuroscience and psychotherapy, has brought about 100% potential for experiential change through putting natural brain plasticity to work FOR rather than against our patients, thereby revolutionising clinical practice in psychotherapy.
The CBT for Tinnitus E-Programme brings these cutting edge practices to anyone suffering because of tinnitus.
Debbie Featherstone MSc
Hearing Therapist, Psychotherapist & CBT Specialist in Tinnitus
CBT for Tinnitus E-Programme
Reviews: Feedback from Users ofCBT for Tinnitus E-Programme (CBT4T)
Personal reviews by people using the CBT for Tinnitus E-Programme are published with permission and include the significant changes each achieved measured by their Tinnitus Functional Index (TFI)
Matt, UK
Matt completed the course back in August 2021. Matt has been thoughtful enough to send a review of how he is TWO YEARS ON - thank you so much Matt! Read Matt's Review "Two Years On"
Nathaniel, UK
Review written at intermediate Stage 6
Tinnitus Functional Index (TFI) 97.6% > 20.8% (category 5: very big problem > category 2: small problem)
Q: Do you recommend others to use the CBT for Tinnitus E-Programme?
A: "Yes absolutely, tinnitus therapy as set out in the course is the only effective treatment for tinnitus and in my case it has certainly worked. It is vital if a path to recovery is to be created that a patient is clear about the causes of tinnitus and the connection between tinnitus and tinnitus distress - having tinnitus and being distressed by tinnitus are not the same. I have used the course in the best way for me - at my own pace - which is what Debbie recommends."
Q: What benefit have you experienced using the relaxation element of the course so far?
A: "I had always struggled with relaxation exercises. I now have a tentative diagnosis of attention deficit disorder which will be further investigated in 2025 and I hope very soon to have a formal diagnosis and begin treatment. Before finding the CBT4T programme, in December '23 my hearing therapist raised the possibility that I might have ADHD after I reported that trying to use the guided relaxation exercises she was giving me seemed to be making my tinnitus anxiety worse. I really struggled too when I started Debbie's course, but with her support I persisted and - as ADHD practitioners also recommend - I worked around my earlier limitations, and have to a significant extent benefited from the relaxation elements of this CBT4T course despite the obstacles I have faced. I have modified my practice to reduce the connection my brain seemed to be making between tinnitus and efforts to relax. I did this by various means including breathing exercises and relaxation while walking, while outdoors, while exercising and in bed. Overall I have significantly increased my level of relaxation and my tinnitus distress is far below the levels it reached this time last year."
Q: How has the neuroscience-based learning about the amygdala, autonomic ladder and brain plasticity helped you to relate to your experience of tinnitus, anxiety and stress?
A: "The science is clear to me and I understand how and why brain plasticity can help in managing tinnitus distress. I have taken very much on board the approach that runs through the course at every level and have done the course according to my capabilities and person circumstances. I have done it at my own pace and drawn back from exercises which generate anxiety and I have had to accept that in my case, particularly in the 2nd half of 2023 before I found this CBT for Tinnitus E-Programme, my forceful efforts to do guided relaxation created strong links in my brain between breathing/relaxation exercises and tinnitus distress. I have worked hard to tailor the course and the practice to my personal circumstances. I have in addition to going at my own pace only produced coursework and written reports as and when my anxiety allows. This is very much something which is affected by ADHD. As well as following this course I have been under the care of my local audiology team and am having 6 monthly review appointments. They are fully supportive of my following the course and are sure that it will help me - indeed it already has. My softly softly approach is allowing brain plasticity to work in my favour."
Q: What have you learned from the costs & benefits transaction work (used from stage 3)? Estimate how much you have already adjusted from having a problem-oriented perspective towards a recovery-oriented perspective (e.g. 2/10 > 7/10 indicates an improvement of 5 so far)
A: "I have not always been able to use Costs & Benefits Transaction tool as frequently as I would like, but I have used it - and the other tools in the course - enough to be able to apply the underlying principles to my daily experience of tinnitus. This has been very positive and I am now very much experiencing a Recovery oriented perspective and I never allow myself to lose sight of the fact that I am managing my tinnitus and not letting it have a debilitating impact on my life. Hand in hand with this I am trying to develop an 'acceptance' perspective which will allow me to accept that I have tinnitus and that while tinnitus itself does not go away, it does not have to generate strong distress or disrupt my day to day activities."
Q: You are likely to have had your first 1-1 by now. Did you benefit from your 1-1 and if so, how?
A: "My first 1 2 1 was such a useful element in the course. I found that talking to someone who understood the experiences I was having and understood the journey I was on towards recovery was hugely beneficial. It is difficult for those who have never experienced tinnitus to understand just how distressing and debilitating it can be to constantly hear a deafening noise which is not caused by anything outside of the body. At the 1 2 1 I was able to ask questions and to receive guidance on how to take my progress further. Talking with Debbie made me feel supported and allowed me to move away from the awful feeling that I had often had that nobody understood the situation I was in and that I would never be able to live a normal life again."
Q: What is your own impression of your progress to date?
A: "I have had to follow the course at my own pace and possibly more slowly than many others, but I feel I have massively benefited from the course to date. From the outset one of the key elements in the therapeutic treatment for tinnitus is 'information' or 'understanding'. That is to be clear about what tinnitus is, how it arises, how it generates distress and hopelessness but also to know that recovery is possible and that even someone with severe intrusive tinnitus can live a normal life. This understanding has allowed me to reduce periods of severe distress to a minimum and the course has also given me the tools to quickly reduce distress when it does occur. At my worst (this time last year) the tinnitus was so overwhelmingly distressing that I could not get through a day without having masking sounds on or walking around outdoors or listening to loud music all the time. I still sometimes wake to hear very loud tinnitus which momentarily upsets me, but I never need to resort to playing music or using masking sounds. I tend to use the lack of need for masking sounds as a measure of how well I am managing my tinnitus."
Ingrid, UK
Interim review written at first repeat stage (Stage 6), 21 weeks after enrolment
Tinnitus Functional Index (TFI) reduced from 67.6% (category 4: big problem) > 22.4% (category 2: small problem)
Q: Do you recommend others to use the CBT for Tinnitus E-Programme?
A: "I would definitely recommend the course to people. I had no idea you needed to embrace relaxation techniques. I had shied away from tinnitus forums as I did not want to engage with others that had it and there was such a range of mixed messages online and with GPs, Audiology, ENT. I was so pleased to find someone who understood the issues that I and many others were having, and the course means that I am tackling tinnitus distress at my own pace."
Q: What benefit have you experienced using the relaxation element of the course so far?
A: "Prior to the course I was not a user of relaxation/meditation and have been really surprised that it has had such an impact on me. I still struggle to do part 1 of the breathing exercise but have really tried just to do the 2 minutes anyway at regular times. I have put a reminder on my phone for mid morning as this is the one I forget with work getting in the way. I have also nodded off to the relaxation half hour sessions which has amazed me. I have also got really good at doing the heavy arms and legs Autogenics programme and really feel the heaviness especially in my arms."
Q: How has the neuroscience-based learning about the amygdala, autonomic ladder and brain plasticity helped you to relate to your experience of tinnitus, anxiety and stress?
A: "I was aware of brain plasticity from previous courses but it has been really helpful to apply this to my experience of tinnitus. Knowing that there is potential for different routes through the brain has helped to believe that tinnitus distress is not hardwired and can be changed by me! The amygdala's role in identifying threats and bringing about fear and anxiety has been really helpful to understand and the need to calm the amygdala down as if it is a physical health wound to our body. The visual colour coded ladder was reassuring as I have not been in the grey zone and understand the importance of the relaxation exercises to move up the ladder."
Q: What have you learned from the costs & benefits transaction work (used from stage 3)? Estimate how much you have already adjusted from having a problem-oriented perspective towards a recovery-oriented perspective (e.g. 2/10 > 7/10 indicates an improvement of 5 so far)
A: "I have tried to work hard in this area of the course with the CBT input as I do not find it easy to do. I feel I was likely to react badly to tinnitus as I am sensitive to external noise, smells and touch of some things so sensory issues and then tinnitus came along and caused tinnitus distress. I have looked back on these areas and made notes to remind myself of cognitive distortions and sections around problems v recovery. I think I was a 1/10 before and currently a 7/10."
Q: You are likely to have had your first 1-1 by now. Did you benefit from your 1-1 and if so, how?
A: "It was good to finally meet with Debbie. It was really helpful to run through some of my concerns such as if I should be wearing hearing aids and to get reassurance that my pace was ok, as it was the pace that I needed to go at. Debbie was very relaxed which made me relaxed - it made me think about my own job and how I can help put vulnerable people that I meet more at ease. It was good to be on the other end for a change and has made me more aware of people's anxiety and how to reduce this during the course of a meeting."
Q: What is your own impression of your progress to date?
A: "I feel the course has a great structure to it which you can go at your own pace. There is no danger of me romping through with some of the material not yet available to me. It is beautifully written, clear and simplifying often complex subjects with options to explore and read further if you so wish. I like the mix of reading, videos and diagrams - something for everyone."
Kirk, USA
Kirk completed his course. Here's his final review - and his review part way through as he completed Stage 6....
Final review from Kirk - 21 weeks after enrolment:
"The Tinnitus E-Programme has been life changing for me. It is very educational and well thought out. I had no idea how connected tinnitus is to the fight or flight reflex, anxiety, etc. The program was easy to follow, included weekly accountability and allows one to progress at their own pace. I’ve completed the program but will be using some of the relaxation and visualization exercises and the other resources for the rest of my life. Excellent program. Amazing results."
Q: Do you recommend others to use the Tinnitus E-Programme and if so, please say why:
A: "Yes! It works!"
Kirk's review written at Stage 6 (10 weeks after enrolment)
- Tinnitus Functional Index (TFI) 52.8% > 16.0% (category 3: 32-53% moderate problem > category 1: 0-17% not a problem)
- Stress (PSS) 17 > 6 (14-26 moderate stress > 0-13 low stress)
- Anxiety (ASQ) 35.3% > 4.7% (31-60% moderate > under 10% negligible)
Q: Do you recommend others to use the CBT for Tinnitus E-Programme?
A: "Yes! Knowing that others have gone before me, and that still others are currently in the course has helped me feel like I’m not alone. I’ve learned a lot and look forward to progressing through the remaining lessons."
Q: What benefit have you experienced using the relaxation element of the course so far?
A: "Having never used breathing or guided relaxation before, I was skeptical. I can now say that these two techniques have been incredibly helpful for me. Using them consistently is the key."
Q: How has the neuroscience-based learning about the amygdala, autonomic ladder and brain plasticity helped you to relate to your experience of tinnitus, anxiety and stress?
A: "Very much so. I never realized there was a relationship between my tinnitus and what was going on in my life regarding stress and anxiety. I always thought my tinnitus was more of a structural condition. Learning the top down vs bottom up way the amygdala works with the upper brain has been fascinating."
Q: What have you learned from the costs & benefits transaction work (used from stage 3)? Estimate how much you have already adjusted from having a problem-oriented perspective towards a recovery-oriented perspective (e.g. 2/10 > 7/10 indicates an improvement of 5 so far)
A: "Reframing my perspective from problem to recovery has been important. I’m a “fixer” by nature so I’m usually recovery oriented in general. But with tinnitus, I was stuck being problem oriented."
Q: You are likely to have had your first 1-1 by now. Did you benefit from your 1-1 and if so, how?
A: "My first 1-1 was great. Debbie helped me understand that the program cannot be rushed, everyone will progress at their own pace. Staying in the program consistently and patiently is the key."
Q: What is your own impression of your progress to date?
A: "Overall I’m feeling less stress and anxiety. My tinnitus still blares most mornings when I wake, but I notice it less during the day. Most days I now wake feeling like I’ve slept better, and I seldom wake up feeling anxious anymore."
This course is specifically for people with very distressing tinnitus. Five clinical measures are used to assess initial severity:
- Tinnitus Functional Index (TFI)
- Tinnitus Handicap Inventory (THI)
- General anxiety (GAD-7)
- Perceived Stress Score (PSS)
- Anxiety/Stress Symptoms Q (ASQ)
These clinical measures are repeated at stages throughout the process in the course to quantify progress and change:
- First repeat is at the end of Stage 6
- Later at either module 9 or 10 - these may be interim or final measures, as some patients do not need the Core Belief work in Module 11
- Final repeat at/post module 12
A Case Study from the 12 Module CBT for Tinnitus E-Programme
An extract from webinar on 30th March 2021: A summary case study of a CBT for Tinnitus E-Programme user
How much change can be expected?
This means how much change in your experience of having tinnitus can you expect
Tinnitus Functional Index (TFI) Category changes following completion of the 12 stage CBT for Tinnitus E-Programme
Average change by TFI value:
- Cat 5 pre-course: 84.9% > 29.9% (Cat 2 post-course)
- Cat 4 pre-course: 64.8% > 20.8% (Cat 2 post-course)
- Cat 3 pre-course: 45.6% > 19.0% (Cat 2 post course)