Cognitive Behavioural Therapy (CBT)

Cognitive behavioural therapy (CBT) is a structured psychological therapy that helps people identify and change negative thought patterns and behaviors that contribute to distress. In audiology, CBT is used primarily in the management of tinnitus, hyperacusis, and hearing-related anxiety. It is delivered by a psychologist or trained therapist, sometimes in collaboration with an audiologist.

Tinnitus distress is not determined solely by the loudness or characteristics of the tinnitus signal. Research consistently shows that the degree of distress is more closely related to how a person interprets and reacts to the tinnitus than to its measured intensity. CBT addresses these interpretive and emotional responses. Techniques include identifying and challenging catastrophic or unhelpful thoughts about tinnitus (such as "this will never get better" or "I cannot function with this sound"), behavioral activation to re-engage with avoided activities, and sleep management strategies.

CBT has strong evidence supporting its effectiveness for tinnitus-related distress and is recommended in several international tinnitus management guidelines. In Canada, CBT for tinnitus is available through some hospital audiology programs, psychological services, and private practice settings. Online CBT programs adapted for tinnitus are also available and have shown efficacy in research trials.