Internet-based audiologist-guided cognitive behavioral therapy for tinnitus : randomized controlled trial

Show simple item record Beukes, Eldre W. Andersson, Gerhard Fagelson, Marc A. Manchaiah, Vinaya 2022-03-10T08:30:58Z 2022-03-10T08:30:58Z 2022-02
dc.description.abstract BACKGROUND : Tinnitus is a symptom that can be very distressing owing to hearing sounds not related to any external sound source. Managing tinnitus is notoriously difficult, and access to evidence-based care is limited. Cognitive behavioral therapy (CBT) is a tinnitus management strategy with the most evidence of effectiveness but is rarely offered to those distressed by tinnitus. The provision of internet-based CBT for tinnitus overcomes accessibility barriers; however, it is not currently readily available in the United States. OBJECTIVE : The aim of this study is to investigate the efficacy of internet-based CBT compared with that of weekly monitoring for the management of tinnitus in reducing tinnitus distress; reducing tinnitus-related comorbidities, including tinnitus cognitions, insomnia, anxiety, and depression; and assessing the stability of the intervention effects 2 months after the intervention. METHODS : A 2-arm randomized clinical trial comparing audiologist-guided internet-based CBT (n=79) to a weekly monitoring group (n=79) with a 2-month follow-up assessed the efficacy of internet-based CBT. Eligible participants included adults seeking help for tinnitus. Recruitment was conducted on the web using an open-access website. Participants were randomized via 1:1 allocation, but blinding was not possible. The study was undertaken by English or Spanish speakers on the web. The primary outcome was a change in tinnitus distress as measured using the Tinnitus Functional Index. Secondary outcome measures included anxiety, depression, insomnia, tinnitus cognition, hearing-related difficulties, and quality of life. RESULTS : Internet-based CBT led to a greater reduction in tinnitus distress (mean 36.57, SD 22) compared with that in weekly monitoring (mean 46.31, SD 20.63; effect size: Cohen d=0.46, 95% CI 0.14-0.77) using an intention-to-treat analysis. For the secondary outcomes, there was a greater reduction in negative tinnitus cognition and insomnia. The results remained stable over the 2-month follow-up period. No important adverse events were observed. Further, 16% (10/158) of participants withdrew, with low overall compliance rates for questionnaire completion of 72.3% (107/148) at T1, 61% (91/148) at T2, and 42% (62/148) at T3. CONCLUSIONS : This study is the first to evaluate and indicate the efficacy of audiologist-delivered internet-based CBT in reducing tinnitus distress in a US population. It was also the first study to offer internet-based CBT in Spanish to accommodate the large Hispanic population in the United States. The results have been encouraging, and further work is indicated in view of making such an intervention applicable to a wider population. Further work is required to improve compliance and attract more Spanish speakers. en_ZA
dc.description.department Speech-Language Pathology and Audiology en_ZA
dc.description.librarian hj2022 en_ZA
dc.description.sponsorship The National Institute on Deafness and Other Communication Disorders of the National Institute of Health en_ZA
dc.description.uri en_ZA
dc.identifier.citation W Beukes E, Andersson G, Fagelson M, Manchaiah V. Internet-Based Audiologist-Guided Cognitive Behavioral Therapy for Tinnitus: Randomized Controlled Trial. Journal of Medical Internet Research. 2022 Feb 14; 24(2): e27584. doi: 10.2196/27584. en_ZA
dc.identifier.issn 1439-4456 (print)
dc.identifier.issn 1438-8871 (online)
dc.identifier.other 10.2196/27584
dc.language.iso en en_ZA
dc.publisher JMIR Publications en_ZA
dc.rights © Eldré W Beukes, Gerhard Andersson, Marc Fagelson, Vinaya Manchaiah. Originally published in the Journal of Medical Internet Research (, 18.09.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License ( en_ZA
dc.subject Cognitive behavioral therapy (CBT) en_ZA
dc.subject eHealth en_ZA
dc.subject Internet intervention en_ZA
dc.subject Randomized controlled trial (RCT) en_ZA
dc.subject Teleaudiology en_ZA
dc.subject Telehealth en_ZA
dc.subject Tinnitus en_ZA
dc.subject Web-based intervention en_ZA
dc.title Internet-based audiologist-guided cognitive behavioral therapy for tinnitus : randomized controlled trial en_ZA
dc.type Article en_ZA

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