Cognitive behavior therapy for tinnitus in integrated primary care: A case example.

OBJECTIVE: Tinnitus is a common and sometimes severely debilitating condition. It has been estimated that approximately 7% of Americans experience tinnitus daily. Hearing difficulties, sleep problems, concentration difficulties, and anxiety are commonly reported associated concerns. Cognitive behavior therapy (CBT) is often recommended to address the psychosocial impact of burdensome tinnitus, as CBT interventions have been shown to be efficacious in reducing tinnitus burden. The presented case demonstrates that a brief (4-session) adapted CBT treatment in an integrated primary care (IPC) setting can result in notable improvements in functioning.

METHOD: Tinnitus severity was monitored with the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI).

RESULTS: The patient reported increased self-efficacy in coping with his tinnitus symptoms. The subjective volume of his tinnitus remained similar over time, but the emotional impact of his symptoms decreased dramatically. Overall THI score decreased from a 48 (moderate impairment) at baseline to a 20 (mild impairment) at discharge. Overall TFI score decreased from a 40 (moderate problem) during first administration to a 9.6 (not a problem) at discharge.

CONCLUSIONS: Brief CBT treatment for tinnitus can be delivered in an IPC setting, consistent with a population-health approach. Such treatment may result in improved quality of life for patients, and the brief approach has the potential to reduce overall cost of care. This case encourages increased identification and treatment of tinnitus within IPC settings, in order to increase access of care for patients with this burdensome condition. (PsycINFO Database Record