LM313 - Should Tinnitus Management Include Audiologist-Led CBT?

Abstract:
One tinnitus management approach with a positive evidence base is Cognitive Behavioral Therapy (CBT), an approach generally provided by a mental health professional with training in CBT. Despite increased access to telehealth and reports of success with internet based CBT (Beukes et al 2018), accessibility to CBT delivered by mental health providers for tinnitus is limited even in areas with good health services. This talk will outline steps taken to identify appropriate practices and to obtain education and training necessary to incorporate audiologist led counseling that includes CBT approaches into the tinnitus services of an established audiology clinic.

Summary:
The growing emphasis on accessibility and affordability of hearing healthcare highlights challenges in the provision of tinnitus management. Although Cognitive Behavioral Therapy (CBT), which is generally provided by a mental health professional with training in CBT, has a positive evidence base, it is not widely available to tinnitus patients. Despite increased access to telehealth and reports of success with internet based CBT, accessibility to CBT delivered by mental health providers for tinnitus is limited. During and post-Covid, mental health services have been in high demand with the result that patients referred for such services may spend years on a waiting list. There has been discussion in both the US and UK about audiologists including CBT based approaches in tinnitus management (eg Henry et al 2022). CBT for tinnitus led by specialist audiologists has been available in the United Kingdom for several years (Aazh et al 2019). Patient acceptance and positive outcomes have been reported to be high. In the US, the VA’s Progressive Tinnitus Management program incorporates mental health provider led CBT as well as counseling and education by audiologists. Outside of the VA, although there are growing numbers of audiologists who provide tinnitus management, and many CEU presentations that discuss CBT for tinnitus, the training needed to prepare audiologists to use aspects of the method are generally not available. Ways for audiologists to obtain CBT education and training leading to services within their scope of practice will be explored. The process of adding audiologist led counseling that incorporates some aspects of CBT to an established tinnitus practice at an audiology clinic within a large medical center will be presented and patient outcomes will be reviewed.