CBT4T 2025 - The Four Elements

CBT4T 2025 - The Four Elements

The 4 CBT4T ELEMENTS are based on the Stages of Change

Stages of Change

Pre-Contemplation - Not interested or not considering change

BEFORE ENROLMENT ON CBT4T

Contemplation - Thinking about change:

  • Identify that we want to change

  • Explore available information

  • Clarify what can help us change

  • Commit to the decision we have made, for example, enrol on CBT4T

AFTER ENROLMENT ON CBT4T

Preparation - Build strong foundations

CBT4T Element 1: Preparation

  • CBT4T Stages 1-3

Action - Making changes

CBT4T Element 2: Moving Forward

  • CBT4T Stages 4-6

CBT4T Element 3: Meaning & Beliefs

  • CBT4T Stage 7

Maintenance - Maintaining changes

CBT4T Element 4: Consolidation & Completion

  • CBT4T Stage 8

Relapse - Temporary Relapses occur intermittently throughout the Change Stages

  • Temporary relapse can occur on any day, any week, any time

  • Progress is not LINEAR - we all experience good days and not so good days

  • Learn to recognise them for what they are, and

  • Know what to do when they happen

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TWO EXAMPLES* of HOW YOU ARE SUPPORTED THROUGH THE STAGES

*Support is not limited to these two examples - there is also email, logs, Progress Checks, and the bespoke electronic CBT tools

SUPPORT EXAMPLE 1: Weekly SITREP

The weekly SITREP was only introduced in to CBT4T in August 2023. It has been become a significant benefit to CBT4T participants. In response to the question:

Q: The weekly SITREP was introduced in August 2023. Have you found it useful to report in weekly and if so, why?, feedback has included:

"It is useful to report in on a weekly basis and it keeps me in touch with the process and keeps my focus as life is busy and can get in the way!" - Ingrid, UK

"Yes, absolutely. Were it not for the SITREP, I think I would have lost focus and engagement, possibly even gone for months at a time without doing any work on the course. Ever since Week 1, I have submitted a weekly SITREP and this has nudged me into reviewing course materials and doing exercises. I think the SITREP is a vital part of the course - without it, I don't think I would have felt as supported as I did. It also represented a record of my progress." - Nathaniel, UK

It is important that you use the CBT4T process consistently and AT YOUR OWN PACE. Any process must fit the individual. Processes will always fail when there is an expectation for individuals to fit a process. Were you to be attending appointments at a clinic, you would go through the process at a pace that suits your needs.

The weekly SITREP is an email that you send in each week. Details about the SITREP, when and how to use it are on the CBT for Tinnitus E-Programme website. Click the button for details:

Weekly SITREP

SUPPORT EXAMPLE 2: Your 1-1 using Zoom

1-1 appointments are carried out using Zoom. 

The optimum time for your first 1-1 with me is 4-6 weeks after starting using the course, so after you begin Element 2: Moving Forward. Your Progress Check 3 as you begin Element 2 triggers booking of the appointment. Please use the Booking Form for your preferred day and time of day.

I have worked remotely since 2012, so even if meeting up on a screen is new to you, it isn't to me.

You do need a good internet connection, which most of us have nowadays, and you can use a computer with camera, microphone and audio, a tablet or a smart phone.

Most one-to-ones are around 60-90 minutes (average 1 hour 20 minutes).  We will have been in touch by email and via your SITREPs, logs and Progress Checks so I'll have a good idea about your needs by then, plus you will have completed a Mini-history.

1-1 appointments

Two appointments are already included in your enrolment. 95% of users don't need any more than TWO 1-1 appointments.

Additional appointments are at the CBT4T rate of £95 per appointment.

CBT4T 2025-1APP

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How does the CBT for Tinnitus E-Programme work?

  • A Warm Welcome!
  • CBT4T 2025 - The Four Elements
  • Feedback/Reviews & Appointments
  • The ABC of Cognitive Behaviour Therapy (CBT)
  • The Tinnitus Functional Index (TFI)
  • CBT4T Substack
  • Website, Blog and Reviews
  • Research underpinning CBT for Tinnitus

Q & As

  • Starting out with the breathing exercise (Stage 1)
  • Doing the breathing exercise in silence
  • Part 1 and Part 2 of the Breathing exercise
  • Relaxation & Meditation
  • Sleep problems
  • Taking breaks away from the course
  • The Meaning Adjuster

Element 1: Preparation | Stage 1 - Clinical Measures & Mini-History

  • Before you begin Stage 1
  • Why are your Clinical Measures Important?
  • Please commit to completing your measures
  • Complete and Send in your Mini-history

Element 1: Preparation | Stage 1 - The Amygdala

  • Bottom>Up, Top>Down Brain Action
  • An Example
  • Neuroscience, Trauma & The CBT for Tinnitus E-Programme
  • Are there exceptions for benefiting from using CBT?
  • To conclude
  • IMPACT STATEMENT

Element 1: Preparation | Stage 1 - Sleep (Optional section)

  • Information about sleep
  • Professor Colin Espie
  • Sleep Diary
  • Professor Matthew Walker
  • Professor Matthew Walker - TED Talk Sleep is your Superpower
  • Professor Matthew Walker - This is how you sleep better

Element 1: Preparation | Stage 1 - Practical

  • Stage 1 Practical
  • How to carry out the breathing exercise
  • Breathing Exercise Instructions
  • Physiological Relaxation & Relaxation Logs

Element 1: Preparation | Stage 1 - Tinnitus Explained

  • Common Triggers
  • The Brain and Tinnitus
  • Tinnitus & the Autonomic Response
  • How tinnitus is managed
  • Hyperacusis - heightened sensitivity to sound
  • "What is the association between tinnitus and hyperacusis?" by Professor David Baguley
  • Weekly SITREP

Element 1: Preparation | Stage 2

Delayed 7 days

  • Progress Check 1
  • How to pace your progress
  • Before you begin Stage 2
  • Stage 2 Practical
  • The Autonomic Ladder
  • How Change Works
  • Maslow's Hierarchy & Human Function
  • Weekly SITREP

Element 1: Preparation | Stage 3

Delayed 17 days

  • Progress Check 2
  • Stage 3 Practical
  • The Neuroscience Behind Change
  • An Important Understanding for a Successful Outcome
  • The 3 Levels of Hearing
  • The Significance of Sound
  • What Stress Does
  • Meaning in Tinnitus
  • Weekly SITREP

Element 2: Moving Forward | Stage 4A

Delayed 24 days

  • Progress Check 3
  • Stage 4 Practical
  • Cognitive Fusion 1 - Firing, Wiring & "Self-talk"
  • Negative Thoughts
  • The Tension Cycle

Element 2: Moving Forward | Stage 4B

Delayed 24 days

  • Cognitive Fusion 2
  • What Cognitive Distortions are behaind your Negative Thoughts?
  • The Iceberg Analogy
  • Cognitive Distortions Practical
  • Before you leave Stage 4

Element 2: Moving Forward | Stage 5A

Delayed 38 days

  • Progress Check 4
  • Stage 5 Practical
  • "Daily Moments" activity for added strengthening of neural pathways
  • Objective vs Subjective Thinking
  • Reaction Analysis or "Spot the links"
  • Meaning Adjuster

Element 2: Moving Forward | Stage 5B

Delayed 38 days

  • Setting your Goals
  • Valued-based Action

Element 2: Moving Forward | Stage 6

Delayed 52 days

  • Progress Check 5
  • Stage 6 Practical
  • Cognitive Reframing
  • Mid-term Measures
  • Brain Plasticity - optional reading
  • Mid-term Progress & Feedback

Element 3: Meaning & Belief | Stage 7 Module 1

Delayed 66 days

  • Stage 7 Practical
  • Taming Tinnitus
  • Continue Practice Reframing

Element 3: Meaning & Belief | Stage 7 Module 2

Delayed 66 days

  • Practical
  • Change the Mind to Change the Brain to Change the Mind 1
  • Change the Mind to Change the Brain to Change the Mind - 2
  • Continue Reframing

Element 3: Meaning & Belief | Stage 7 Module 3

Delayed 80 days

  • Repeat Clinical Measures
  • Practical
  • The Beck Thought Record for Reframing
  • Core Belief Identification (Self)
  • Core Belief Identification (Others)
  • Core Belief Identification (The World/My Life)

Element 3: Meaning & Belief | Stage 7 Module 4 Identify New Core Belief

Delayed 80 days

  • Identify New Core Belief
  • New Core Belief Record
  • Rate Confidence in the New Core Belief

Element 4: Consolidate & Completion | Stage 8

Delayed 80 days

  • Practical
  • Reframing Practice
  • Neuroscience Research - Tinnitus
  • Tinnitus and the Power of Prediction | Dr Will Sedley
  • Measuring your progress

Element 4: Consolidate & Completion | Stage 8 Final Module

Delayed 80 days

  • Final Practical
  • Reframing Practice
  • Completing this process
  • Final Progress Check
  • Completing the process