Cognitive-behavioral treatments for tinnitus: a review of the literature

J Am Acad Audiol. 2014 Jan;25(1):29-61. doi: 10.3766/jaaa.25.1.4.


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.

Publication types

  • Review

MeSH terms

  • Acoustic Stimulation
  • Adaptation, Psychological*
  • Cognitive Behavioral Therapy / methods*
  • Cognitive Behavioral Therapy / trends
  • Evidence-Based Practice*
  • Humans
  • Outcome Assessment, Health Care*
  • Patient Care Team
  • Perceptual Masking
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Stress, Psychological / etiology
  • Stress, Psychological / psychology
  • Stress, Psychological / therapy*
  • Tinnitus / complications
  • Tinnitus / psychology
  • Tinnitus / therapy*