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    Tinnitus Relief: Therapy Mix Helps Ringing in Ears

    Combining Parts of Sound Retraining and Talk Therapy Can Give Relief

    Tinnitus: Combining Treatments continued...

    In typical tinnitus retraining therapy, counseling sessions and exposure to a neutral external sound are used, Cima says.

    "A sound generator is prescribed to patients," Cima says. "It generates a sound. The theory is that by listening to this masking sound the patients will [get used] to it, as well as to their tinnitus."

    However, what is new, Cima tells WebMD, is that they combined the audiological and psychological treatments within a behavioral framework. In her approach, the behavioral intervention and the sound intervention are carried out at the same time.

    "We believe that not the sound itself but the reactions (fear and misinterpretations) to this sound determine whether or not people will develop complaints," she says.

    She focuses on modifying the reactions to the sounds. Patients often want to avoid the tinnitus, she says. They do this by not wanting to stay in silent environments, for instance.

    "I say often to patients: 'In order to [get used] to your tinnitus, you have to be willing to perceive your tinnitus.'"

    After that first step, those with more severe tinnitus went on to a second step, which included group treatment with a variety of therapists.

    Combining Treatments: Results

    After 12 months, those in the specialized care group reported better quality of life, less severity of the tinnitus, and decreased impairment compared to the usual-care group.

    Many had dropped out of each group. In all, 161 finished all 12 months of the usual care; 171 completed the combined approach.

    Ideally, Cima says, the patients can keep using the skills learned in the program. If they have remission, they can return for more treatment, she says.

    Information on costs is not yet available, she says.

    Tinnitus Treatments: Expert Opinions

    While the treatments used in the new study have been around for decades, the new research documents that it works in a scientific way, says William Martin, PhD, director of the Tinnitus Clinic and Tinnitus Research at the Oregon Health and Science University in Portland.

    "It's not groundbreaking," he says of the combination approach, "but it is an important step in terms of documenting how we should be approaching these poor people."

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