Delivery of internet-based cognitive behavioral therapy combined with human-delivered telepsychology in tinnitus sufferers through a chatbot-based mobile app
Open accessAbstract
Background While there is no cure for tinnitus, research has shown that cognitive behavioral therapy (CBT) is effective in managing clinical sequelae. Although traditional CBT is labor-intensive and costly, new online consultations may improve accessibility. Moreover, there is promise in an engaging conversational agent, or a “chatbot,” delivering CBT in a conversation-like manner and allowing users to work through complex situations with the guidance of a virtual coach. Currently, there is little research examining a possible hybrid model using iCBT and tele consultation with a psychologist. Methods A randomized, 2 parallel-group trial was conducted to compare the clinical effectiveness of (1) iCBT delivered through a chatbot mobile app (i.e., Tinnibot only group) (2) Tinnibot combined with telepsychology (i.e., hybrid-intervention group). A total of 30 eligible adults with tinnitus were included. After an 8-week intervention period, participants were followed up for 2 months. The primary outcome measure, the Tinnitus Functional Index (TFI), and the secondary outcome measures, Hyperacusis Questionnaire (HQ), Generalized Anxiety Disorder 7-item (GAD-7), and Patient Health Questionnaire (PHQ-9), were assessed before treatment, post-treatment, and at follow-up. Results The TFI decreased significantly over time in both groups, with a trend for a larger improvement in the group that received telepsychology. At post-treatment, a clinically significant improvement was observed in 42% of the Tinnibot-only group and 64% of the hybrid-intervention group. At follow-up, this was 64% for both groups. The secondary outcome measures, PHQ-9 and GAD-7 improved significantly over time, but the HQ did not. Discussion Internet-based delivery of CBT is effective in decreasing tinnitus distress, and levels of anxiety and depression, which is more relevant today than ever in the context of a global pandemic that has challenged the delivery of face-to-face intervention. The addition of telepsychology might be beneficial, but not essential for the effectiveness of treatment. There is a need for further research to determine whether there is any relationship between the characteristics of tinnitus patients and the success of the different modes of delivery of therapy.
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The iCBT mobile application "Timibot" significantly alleviated tinnitus distress and, when combined with remote psychological counseling, enabled rapid symptom improvement in the early stages of treatment.
“It significantly alleviated tinnitus distress and, when combined with remote psychological counseling, enabled rapid symptom improvement in the early stages of treatment.”
From Research trends and hotspots of cognitive behavioral therapy for tinnitus: a bibliometric analysis (2025) · cites this paper as Bardy et al., 2024
The Primary outcome measure section (page unavailable) reports that tinnitus distress decreased significantly over time in both the Tinnibot-only and hybrid groups. The Discussion (page unavailable) describes faster improvement with added telepsychology only as a trend, with no significant difference between groups. The claim overstates the evidence that counseling enabled rapid early improvement. (LLM, conf=0.90)
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Cites
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · see citing works
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802 · see citing works
Fitzpatrick, K. K., Darcy, A., & Vierhile, M. (2017) · JMIR Mental Health · doi:10.2196/mental.7785 · Cited by 2,730 · see citing works
Mindfulness and acceptance: expanding the cognitive-behavioral tradition
(2005) · Choice Reviews Online · doi:10.5860/choice.42-6797 · Cited by 1,273 · see citing works
Baguley, D., McFerran, D., & Hall, D. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60142-7 · Cited by 1,245 · see citing works
The Tinnitus Functional Index: Development of a New Clinical Measure for Chronic, Intrusive Tinnitus
Meikle, M. B., Henry, J. A., Griest, S. E., Stewart, B. J., Abrams, H. B., McArdle, R., Myers, P. J., Newman, C. W., Sandridge, S., Turk, D. C., et al. (2012) · Ear & Hearing · doi:10.1097/aud.0b013e31822f67c0 · Cited by 792 · see citing works
Psychometric Normalization of a Hyperacusis Questionnaire
Khalfa, S., Dubal, S., Veuillet, E., Perez-Diaz, F., Jouvent, R., & Collet, L. (2002) · ORL · doi:10.1159/000067570 · Cited by 488 · see citing works
Prevalence, Severity, Exposures, and Treatment Patterns of Tinnitus in the United States
Bhatt, J. M., Lin, H. W., & Bhattacharyya, N. (2016) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2016.1700 · Cited by 460 · see citing works
A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment
Cima, R. F. F., Mazurek, B., Haider, H., Kikidis, D., Lapira, A., Noreña, A., & Hoare, D. J. (2019) · HNO · doi:10.1007/s00106-019-0633-7 · Cited by 442 · see citing works
Andersson, G. (2002) · Psychosomatic Medicine · doi:10.1097/01.psy.0000031577.42041.f8 · Cited by 312 · see citing works
A scientific cognitive-behavioral model of tinnitus: Novel conceptualizations of tinnitus distress.
McKenna, L., Handscomb, L., Hoare, D. J., & Hall, D. A. (2014) · Frontiers in Neurology · doi:10.3389/fneur.2014.00196 · Cited by 232 · see citing works
Cognitive behavioural therapy for tinnitus
Fuller, T., Cima, R., Langguth, B., Mazurek, B., Vlaeyen, J. W., & Hoare, D. J. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012614.pub2 · Cited by 212 · see citing works
Donkin, L., Hickie, I. B., Christensen, H., Naismith, S. L., Neal, B., Cockayne, N. L., & Glozier, N. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2771 · Cited by 193 · see citing works
Oh, J., Jang, S., Kim, H., & Kim, J.-J. (2020) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2020.104171 · Cited by 124 · see citing works
An economic evaluation of the healthcare cost of tinnitus management in the UK
Stockdale, D., McFerran, D. J., Brazier, P., Pritchard, C., Kay, T., Dowrick, C. F., & Hoare, D. J. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2527-2 · Cited by 108 · see citing works
Beukes, E. W., Baguley, D., Allen, P. M., Manchaiah, V. K. C., & Andersson, G. (2017) · Ear and Hearing · doi:10.1097/aud.0000000000000505 · Cited by 106 · see citing works
McKenna, L., Marks, E. M., Hallsworth, C. A., & Schaette, R. (2017) · Psychotherapy and Psychosomatics · doi:10.1159/000478267 · Cited by 93 · see citing works
Beukes, E. W., Andersson, G., Allen, P. M., Manchaiah, V. K. C., & Baguley, D. (2018) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2018.2238 · Cited by 88 · see citing works
Gander, P. E., Hoare, D. J., Collins, L., Smith, S., & Hall, D. A. (2011) · BMC Health Services Research · doi:10.1186/1472-6963-11-162 · Cited by 65 · see citing works
Natural history of tinnitus in adults: a cross-sectional and longitudinal analysis
Dawes, P., Newall, J. P., Stockdale, D., & Baguley, D. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-041290 · Cited by 52 · see citing works
Jacquemin, L., Mertens, G., de Heyning, P. V., Vanderveken, O. M., Topsakal, V., Hertogh, W. D., Michiels, S., Rompaey, V. V., & Gilles, A. (2019) · Hearing Research · doi:10.1016/j.heares.2019.107796 · Cited by 46 · see citing works
Self-citationHoare, D. J., Broomhead, E., Stockdale, D., & Kennedy, V. (2015) · European Journal for Person Centered Healthcare · doi:10.5750/ejpch.v3i3.984 · Cited by 43 · see citing works
Cost of Care for Subjective Tinnitus in Relation to Patient Satisfaction
Goldstein, E. D., Ho, C., Hanna, R., Elinger, C., Yaremchuk, K., Seidman, M. D., & Jesse, M. T. (2015) · Otolaryngology · doi:10.1177/0194599814566179 · Cited by 43 · see citing works
Boecking, B., Biehl, R., Brüeggemann, P., & Mazurek, B. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10132798 · Cited by 37 · see citing works
Effectiveness of telerehabilitation interventions for self-management of tinnitus: systematic review
Demoen, S., Chalimourdas, A., Timmermans, A., Van Rompaey, V., Vanderveken, O. M., Jacquemin, L., Schlee, W., Marneffe, W., Luyten, J., Gilles, A., et al. (2023) · Journal of Medical Internet Research · doi:10.2196/39076 · Cited by 24 · see citing works
Self-citationAndrade, S. (1998) · Value in Health · doi:10.1046/j.1524-4733.1998.130171.x · Cited by 15 · see citing works
Handscomb, L., Shorter, G. W., Hoare, D. J., & Hall, D. A. (2019) · Ear and Hearing · doi:10.1097/aud.0000000000000826 · Cited by 11 · see citing works
Rodrigo, H., Beukes, E. W., Andersson, G., & Manchaiah, V. K. C. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-049384 · Cited by 11 · see citing works
Multidisciplinary Tinnitus Care
Henry, J. A., McMillan, L. R., & Manning, C. A. (2019) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2019.07.017 · Cited by 10 · see citing works
Marks, E. M., Handscomb, L., & Remskar, M. (2022) · International Journal of Audiology · doi:10.1080/14992027.2022.2063195 · Cited by 5 · see citing works
Lourenço, M. G., Fuller, T., Ranson, S., Vlaeyen, J., & Cima, R. (2022) · Ear and Hearing · doi:10.1097/aud.0000000000001261 · Cited by 5 · see citing works
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The Use of Artificial Intelligence for Personalized Treatment in Psychiatry
Jalali, S., You, Q., Xu, V., Chen, L., Zini, J., Zamorano, T., Luo, Y., Friesen, T., Fontana, G. J., & Benrimoh, D. A. (2025) · Current Psychiatry Reports · doi:10.1007/s11920-025-01656-y · Cited by 8 · see citing works
Cavalera, C., Frisone, F., Rossi, C., Oasi, O., Pagnini, F., Riva, G., & Antichi, L. (2026) · Current Psychiatry Reports · doi:10.1007/s11920-026-01690-4 · Cited by 5 · see citing works
Brice, S., Zakis, J. A., & Almond, H. M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13154538 · Cited by 4 · see citing works
Sarnicka, I., Raj-Koziak, D., Skarżyńśki, H., Fludra, M., Karendys-Łuszcz, K., & Gos, E. (2024) · Journal of Hearing Science · doi:10.17430/jhs/191396 · Cited by 4 · see citing works
Research trends and hotspots of cognitive behavioral therapy for tinnitus: a bibliometric analysis
He, Y., Liu, J., Cheng, H., Ye, H., Li, C., Gao, Y., & Xu, X. (2025) · Frontiers in Neuroscience · doi:10.3389/fnins.2025.1536224 · Cited by 2 · see citing works
Usability and desirability of a hearing health chatbot: an explorative study
Bennett, R. J., Tsiolkas, J., & Tagudin, J. (2025) · International Journal of Audiology · doi:10.1080/14992027.2025.2514586 · Cited by 2 · see citing works
van der Wal, A., Lobbezoo, F., van Gorkum, R., Su, N., & Korfage, H. A. M. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14041166 · Cited by 1 · see citing works
Digital Tinnitus Counseling in Clinical Practice: A Multicenter Randomized Controlled Trial
Brueggemann, P., Supp, G. G., Schmidt, P. J., & Mazurek, B. (2025) · Audiology Research · doi:10.3390/audiolres15060173 · Cited by 1 · see citing works
Kanzaki, S., Wasano, K., Hirao, T., Kurihara, M., Ishikawa, Y., Yokota, M., Yageta, Y., Nawata, S., & Izawa, S. (2026) · Auris Nasus Larynx · doi:10.1016/j.anl.2026.01.009 · Cited by 1 · see citing works
Jackson, J. G., Yeates, F., Morris, B., Hollands, S., & Drybrough, G. (2026) · Internet Interventions · doi:10.1016/j.invent.2026.100944 · Cited by 1 · see citing works
Perceived barriers and facilitators to app use in Australian audiology clinics
Bennett, R. J., Ferguson, M., Tsiolkas, J., Ravichandran, A., Bamber, J. D. L., & Saunders, G. H. (2026) · International Journal of Audiology · doi:10.1080/14992027.2026.2658538 · Cited by 1 · see citing works
Poojary, S. C., & Nayak, P. (2026) · International Journal of Otorhinolaryngology and Head and Neck Surgery · doi:10.18203/issn.2454-5929.ijohns20262381
Artificial intelligence analytics for diagnosis, prognosis, and outcomes prediction
Jalali, S., You, Q., Xu, V., Chen, L., Zini, J., Zamorano, T., Luo, Y., Friesen, T., Fontana, G. J., & Benrimoh, D. A. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-33151-0.00009-5
Magami, K., Yata, H., Kabe, Y., Kanzaki, S., Hayashi, K., & Takahashi, H. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1787660
- Authors
- Bardy, F., Jacquemin, L., Wong, C. L., Maslin, M. R. D., Purdy, S. C., & Thai-Van, H.
- Affiliations
- University of Auckland (NZ)
- University of Antwerp (BE)
- Corresponding author
- Bardy, Fabrice
- Venue
- Frontiers in Audiology and Otology
- Publisher
- Frontiers Media SA
- Published
- 2024-01-09
- Volume
- 1
- ISSN
- 2813-6055 (ISSN-L)
- OpenAlex
- W4390726468
- Cited by
- 14
- References
- 31
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 2
- FWCI
- 5.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Audiology and Otology (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- ResearchSpace (University of Auckland) (submittedVersion, cc-by)
- Funders
- Fondation Pour l'Audition (FPA IDA10, FPA IDA09)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- tinnitus, cognitive behavioral therapy, internet-based cognitive behavioral therapy, chatbots, mobile application, telepsychology, hybrid intervention, Tinnitus Functional Index, hyperacusis, anxiety, depression, tinnitus distress, COVID-19 pandemic
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