Cognitive-behavioral treatments for tinnitus: a review of the literature
Abstract
BACKGROUND: Tinnitus can be defined as the perception of an auditory sensation, perceivable without the presence of an external sound. PURPOSE: The aim of this article is to systematically review the peer-reviewed literature on treatment approaches for tinnitus based on cognitive-behavioral therapy (CBT) and to provide a historical overview of developments within these approaches. RESEARCH DESIGN: Experimental studies, (randomized) trials, follow-up assessments, and reviews assessing educational, counseling, psychological, and CBT treatment approaches were identified as a result of an electronic database metasearch. RESULTS: A total of 31 (of the initial 75 studies) were included in the review. Results confirm that CBT treatment for tinnitus management is the most evidence-based treatment option so far. Though studied protocols are diverse and are usually a combination of different treatment elements, and tinnitus diagnostics and outcome assessments vary over investigations, a common ground of therapeutic elements was established, and evidence was found to be robust enough to guide clinical practice. CONCLUSIONS: Treatment strategy might best be CBT-based, moving toward a more multidisciplinary approach. There is room for the involvement of different disciplines, using a stepped-care approach. This may provide brief and effective treatment for a larger group of tinnitus patients, and additional treatment steps can be provided for those suffering on a more severe level.
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CBT has been proven to significantly reduce tinnitus-related distress, anxiety, and depression, and improve quality of life for tinnitus patients.
“it has been proven to significantly reduce tinnitus-related distress, anxiety, and depression, and improve the quality of life for tinnitus patients (Cima et al., 2014).”
From Research trends and hotspots of cognitive behavioral therapy for tinnitus: a bibliometric analysis (2025) · cites this paper as Cima et al., 2014
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Self-citationCognitive behavioural therapy for tinnitus
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“A prime empirical example of multi-point control is cognitive behavioral therapy, which offers a spatio-temporal pattern of activations that enhances cognitive function and decreases psychiatric symptoms across diagnostic categories (Lett et al., 2014; Radhu et al., 2012; Cima et al., 2014).”
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The Analogy between Tinnitus and Chronic Pain: A Phenomenological Approach
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Theodoroff, S. M., McMillan, G. P., Schmidt, C. J., Dann, S. M., Hauptmann, C., Goodworth, M.-C. R., Leibowitz, R. Q., Random, C., & Henry, J. A. (2021) · International Journal of Audiology · doi:10.1080/14992027.2021.2004325 · Cited by 6 · see citing works
“Overall, CBT for tinnitus focuses on mitigating emotional reactions, teaching distraction and relaxation behaviours, and offering patients problem-solving techniques and coping strategies to resolve tinnitusdistress (Cima et al. 2014).”
BackgroundSelf-citationTranslation and validation of the Tinnitus Primary Function Questionnaire into Brazilian Portuguese
Coradini, P. P., Gonçalves, S. N., & Oiticica, J. (2022) · Brazilian Journal of Otorhinolaryngology · doi:10.1016/j.bjorl.2022.06.004 · Cited by 6 · see citing works
A device and an app for the diagnosis and self-management of tinnitus
Vittorini, P., Chamoso, P., & la Prieta, F. D. (2022) · Berichte aus der medizinischen Informatik und Bioinformatik/Journal of integrative bioinformatics · doi:10.1515/jib-2022-0004 · Cited by 6 · see citing works
“In the specific case of chronic tinnitus, cognitive behavioural therapy is currently themost accredited approach [54], sometimes associated with a pharmacological therapy.”
BackgroundEffectiveness of a Cognitive Behavioral Therapy-Based Exercise Program for Healthy Employees
Takechi, S., Kikuchi, T., Horisawa, S., Nakagawa, A., Yoshimura, K., & Mimura, M. (2015) · Advances in Physical Education · doi:10.4236/ape.2015.54031 · Cited by 6 · see citing works
“CBT programs for chronic pain (Ehde, Dillworth, & Tuner, 2014), dizziness (Cima et al., 2014), and dieting have been developed (Beck, 2007); Tsiros et al. (2008) verified the effectiveness of a CBT-based program for diet (Tsiros, 2008).”
BackgroundErdman, S. A., Scherer, R. W., Sierra-Irizarry, B., & Formby, C. (2019) · American Journal of Audiology · doi:10.1044/2019_aja-18-0068 · Cited by 5 · see citing works
Demoen, S., Jacquemin, L., Timmermans, A. A. A., Rompaey, V. V., Vanderveken, O. M., Vermeersch, H., Joossen, I., Eetvelde, J. V., Schlee, W., Marneffe, W., et al. (2022) · Trials · doi:10.1186/s13063-022-06378-7 · Cited by 5 · see citing works
TINNITUS – EVALUACIÓN Y MANEJO
Curet, C. A., & Roitman, D. (2016) · Revista Médica Clínica Las Condes · doi:10.1016/j.rmclc.2016.11.017 · Cited by 5 · see citing works
Sound Therapy for Tinnitus: Options for Audiologists
Henry, J. A., & Quinn, C. M. (2020) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/2020_persp-19-00156 · Cited by 5 · see citing works
Self-citationMomentary Assessment of Tinnitus—How Smart Mobile Applications Advance Our Understanding of Tinnitus
Schlee, W., Kraft, R., Schobel, J., et al. (2022) · Studies in neuroscience, psychology and behavioral economics · doi:10.1007/978-3-030-98546-2_16 · Cited by 5 · see citing works
Impact of Tinnitus on Cognitive Function in Forensic Neuropsychology Context
Schultz, I. Z., Sepehry, A. A., & Greer, S. C. (2018) · Psychological Injury and Law · doi:10.1007/s12207-018-9321-2 · Cited by 5 · see citing works
Optimal Trajectories of Brain State TransitionsPreprint
Gu, S., Betzel, R. F., Cieslak, M., et al. (2016) · arXiv (Cornell University) · doi:10.48550/arxiv.1607.01706 · Cited by 5 · see citing works
“A prime empirical example of multi-point control is cognitive behavioral therapy, which offers a spatio-temporal pattern of activations that enhances cognitive function and decreases psychiatric symptoms across diagnostic categories (Lett et al., 2014; Radhu et al., 2012; Cima et al., 2014).”
Steinmetzger, K., Schiele, T., Boecking, B., Avraamides, M. N., Bamidis, P. D., Basso, L., Dobel, C., Gilou, S. C., Ioannou, C. I., Shimi, A. G., et al. (2024) · Frontiers in Audiology and Otology · doi:10.3389/fauot.2024.1347283 · Cited by 4 · see citing works
Attention-Modulated Cortical Responses as a Biomarker for Tinnitus
Richardson, M. L., Luo, J., & Zeng, F. (2024) · Brain Sciences · doi:10.3390/brainsci14050421 · Cited by 4 · see citing works
“Currently, clinical interventions like cognitive behavioral therapy and perceptual training [74–78] attempt to manipulate attention away from tinnitus to facilitate its habituation.”
BackgroundOstermann, T., Boehm, K., & Kusatz, M. (2016) · BMC Health Services Research · doi:10.1186/s12913-016-1644-7 · Cited by 4 · see citing works
“A recent review of 31 studies [11] found multidisciplinary CBT-based tinnitus treatment the most promising option for treating patients with tinnitus.”
BackgroundBrüeggemann, P., Szczepek, A. J., Seydel, C., Schaefer, C. J., Amarjargal, N., Boecking, B., Rose, M., & Mazurek, B. (2019) · HNO · doi:10.1007/s00106-019-0618-6 · Cited by 4 · see citing works
Cone, J. E., Stein, C. R., Lee, D. J., et al. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16203864 · Cited by 4 · see citing works
“Finally, studies are needed to determine if administration of proven psychological and pharmacological post-trauma interventions and other stress management strategies might also serve to reduce adverse auditory system effects following future disasters [37,38].”
BackgroundWhat Has EMDR Taught Us About the Psychological Characteristics of Tinnitus Patients?
Moore, T., Phillips, J. S., Erskine, S. E., & Nunney, I. (2020) · Journal of EMDR Practice and Research · doi:10.1891/emdr-d-19-00055 · Cited by 4 · see citing works
Skarzynski, P. H., Świerniak, W., Rajchel, J. J., Bieńkowska, K. I., Dziendziel, B., & Skarżyńśki, H. (2020) · Nowa Audiofonologia · doi:10.17431/903759 · Cited by 4 · see citing works
Husain, F. T. (2021) · The Psychology of learning and motivation/The psychology of learning and motivation · doi:10.1016/bs.plm.2021.02.002 · Cited by 4 · see citing works
Impact of Pain on Cognitive Function in Forensic Neuropsychology Context
Schultz, I. Z., Sepehry, A. A., & Greer, S. C. (2018) · Psychological Injury and Law · doi:10.1007/s12207-018-9318-x · Cited by 4 · see citing works
Exposure-based Interventions for Chronic Pain and Bodily Symptoms: A Special Interest Meeting Report
Schemer, L., Glogan, E., Sjouwerman, R., Ahm, R., Ashar, Y. K., Boddez, Y., Boersma, K., Cañeiro, J. P., Cima, R. F. F., den Hollander, M., et al. (2026) · Behaviour Research and Therapy · doi:10.1016/j.brat.2026.104998 · Cited by 3 · see citing works
“…involve activities known to exacerbate tinnitus, such as engaging in activities with high contrast: including sound perception (noisy vs silent environments), physical activity (physically active vs physically relaxed engagements), and mental activity (mentally demanding tasks vs. relaxed states).”
Self-citationPsychological Models of Tinnitus
Dauman, N., Hobeika, L., Erlandsson, S., Cima, R. F. F., McKenna, L., Samson, S., & Londero, A. (2024) · Springer eBooks · doi:10.1007/978-3-031-35647-6_21 · Cited by 4 · see citing works
Self-citationEffectiveness of cognitive behavioral therapy in relieving tinnitus
Bal, F. (2024) · The International Journal of Psychiatry in Medicine · doi:10.1177/00912174241272674 · Cited by 4 · see citing works
“36 CBT-based treatments have been found to have long-term bene fi cial effects and have been effective both in individual and group settings.”
Hoetink, A. E., Kaldenbach, S., Lieftink, A., Versnel, H., & Stokroos, R. J. (2024) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1451741 · Cited by 3 · see citing works
- Authors
- Cima, R. F. F., Andersson, G., Schmidt, C. J., & Henry, J. A.
- Affiliations
- Maastricht University (NL)
- Linköping University (SE)
- Yale University (US)
- Oregon Health & Science University (US)
- Venue
- Journal of the American Academy of Audiology
- Publisher
- American Academy of Audiology
- Published
- 2014-01-01
- Volume
- 25
- Issue
- 1
- Pages
- 29-61
- ISSN
- 1050-0545 (ISSN-L)
- OpenAlex
- W2123714624
- Cited by
- 155
- References
- 0
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 12 · 2023: 13 · 2022: 15 · 2021: 9 · 2020: 23 · 2019: 18 · 2018: 16 · 2017: 9 · 2016: 14 · 2015: 13 · 2014: 2 · 2013: 1
- FWCI
- 7.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Audiology (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (acceptedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
- Health Sciences › Health Professions › Speech and Hearing › Noise Effects and Management
- Keywords
- tinnitus, cognitive behavioral therapy, tinnitus treatment, evidence-based treatment, stepped care, multidisciplinary care, counseling, psychological intervention
- MeSH terms
- Acoustic Stimulation, Adaptation, Psychological, Humans, Patient Care Team, Perceptual Masking, Severity of Illness Index, Stress, Psychological, Tinnitus, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Evidence-Based Practice
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