Självhjälpsbehandling mot tinnitusbesvär (Self-Help Treatment for Tinnitus Symptoms)

Description:

This self-help program includes lessons on relaxation, imagery, hearing tactics, breathing, noise sensitivity, changing negative thoughts and beliefs. All of the modules include homework assignments and weekly reports. Participants can ask questions of the investigators via email and receive feedback and encouragement.

Service URL:

http://medsys.uas.se/tinnitus

Agency Responsible:

Uppsala University.

Details

Format:

Website.

Intervention Type:

Psychological – CBT.

Course Length:

Long (more than 5 modules). 10 components over 6 modules.

Support Option:

Clinical support.

Target Audience

Primary Category:

Tinnitus.

Target Audience:

Adult.

Language:

Swedish.

Access

Fee:

Free.

Access:

Closed: Research participation.

Contact Details:

sven.alfonsson@akademiska.se

Research evidence

Research Trials:

4

Research RCTs:

1

Outcome Summary:

A randomised controlled trial was conducted, which compared the online CBT self-help manual (n=53) to a wait-list control (n=64). The results of this study found that tinnitus related distress, depression and diary ratings of annoyance reduced significantly more in the treatment group, than in the control group.  29% of people in the treatment group, compared to 4% in the control group, had a clinically significant improvement on the Tinnitus Reaction Questionnaire (TRQ; 50% reduction in score). However, when drop outs were included in an intention to treat (ITT)analysis, there was no longer a significant difference. A second study involvong middle aged females with tinnitus, found that the online treatment program resulted in a reduction of 10 points on the TRQ, and decreased scores on depression scales at post treatment and after 3 months.
In a third non-randomised clinical effectiveness study with a sample of referred clinical patients,  ITT analyses showed a reduction in distress on the TRQ at post treatment and 3-month follow up. 27.3% of participants showed a 50% reduction in TRQ scores (clinically significant) at post treatment and this reduction continued for 23.4% of participants at 3 month follow up. In a final study,  the online CBT (n=26) program was compared to a standard group based CBT (n=25) program for tinnitus. Results of this study showed that both groups improved, with little difference between them. At post treatment, 38% of the Internet participants and 44% of the group CBT participants showed clinically significant change on the TRQ.

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Research paper citations

1. Andersson, G., Strömgren, T., Ström, L., & Lyttkens, L. (2002). Randomized controlled trial of Internet-based cognitive behavior therapy for distress associated with tinnitus. Psychosomatic Medicine, 64, 810-816.
2. Andersson, G., Kaldo, V. (2004). Internet-based cognitive behavioral therapy for tinnitus. Journal of Clinical Psychology, 60, 171-178.
3. Kaldo-Sandstrom, V., Larsen, H. C., & Andersson, G. (2004). Internet-based cognitive-behavioral self-help treatment of tinnitus: Clinical effectiveness and predictors of outcome. American Journal of Audiology,  13, 185-192.
4. Kaldo, V., Levin, S., Widarsson, J., Buhrman, M., Larsen, H. C., & Andersson, G. (2008). Internet versus group cognitive-behavioral treatment of distress associated with tinnitus. A randomised controlled trial. Behavior Therapy, 39, 348-359.