Intro
Everyone including you coming to the Tinnitus E-Programme comes with their own story and background, and as we all know, we are all different! We have different strengths, different abilities, different characteristics and different expectations!
CBT is acknowledged to be the only clinical intervention with a strong evidence-base for reducing tinnitus distress. Before embarking on the process, it is really important that you understand what CBT for Tinnitus is for. I use one Guiding Principle to explain.
CBT is acknowledged to be the only clinical intervention with a strong evidence-base for reducing tinnitus distress. Before embarking on the process, it is really important that you understand what CBT for Tinnitus is for. I use one Guiding Principle to explain.
The first thing to do is to complete your initial TFI (Tinnitus Functional Index) and THI (Tinnitus Handicap Inventory). I would encourage you to complete your TFI & THI questionnaires before you enrol on the course. Here are the links on the TEP website:
If you found the TEP via the Tinnitus E-Programme website, you may have already completed them. That's great! No need to do another!
I ask you to complete your TFI & THI for two reasons:
- Completing them gives you your starting point. It reflects how you have been coping with tinnitus over the past week to two weeks. It gives you a measure that is used to "measure" how much you progress and improve through using the course. You'll complete them again at the very end of the TEP, and your score will have reduced - most commonly by at least 2 of the THI categories - unless your THI score is 18-36% (category 2: mild tinnitus distress) as there is only one category to come down to (category 1: 0-16 no tinnitus distress)
- The second reason is that when you press SEND at the end of the TFI & THI, you receive a copy of your answers, and they also come through to me. I will be working with you after you enrol, so it gives me an idea of how well you are currently coping in terms of tinnitus distress.
In addition to your TFI & THI, I also ask that you complete and send in your GAD-7 that gives a measure of anxiety, and also a brief history of what has happened in terms of your tinnitus to date - it is called your Mini-history.
As soon as you enrol, you have access to all the materials in Module 1. The reading is not onerous, and doesn't take huge chunks of time for any of the modules.
The Tinnitus E-Programme is not a "book about tinnitus". If you want a good, informative book about tinnitus, one of the best ones around is "Living with Tinnitus and Hyperacusis" by Laurence McKenna, David Baguley and Don McFerran.
The Tinnitus E-Programme is a hands on, practical, module-based course of treatment for tinnitus distress.
One of the elements of 'tinnitus treatment' (tinnitus management) is "education", and the Tinnitus E-Programme walks you through that process.
Module 1 starts you on that process, and includes not only the basics of the mechanism of tinnitus, but even more importantly, why and how to begin making the necessary physiological changes. The practical element of the Tinnitus E-Programme is THE most significant aspect of changing the experience of tinnitus from being distressing - with all that 'distress' entails - to reducing distress.
As well as the very easy practical exercise(s) throughout the course, I have included the neuroscience behind them. Neuroscience is basically the "brain science" behind what's going on both in terms of neurochemistry (chemical changes in the brain) and neurobiological systems (the nervous systems in the body). I have included additional optional reading about this for those with a particular interest in it all.
A Brief Background
Historically, from 2009 until mid-2018, the Tinnitus E-Programme provided an online self-directed course of Tinnitus Management. Materials used were the same as those I use in my NHS clinics.
8 years on, following analysis of its use during 2017 and 2018, since the completion of an independent evaluation by NHBRC (Nottingham Hearing Biomedical Research Centre) and the introduction of mandatory submission of initial THI (Tinnitus Handicap Inventory) mid-2017, it became clear that being entirely self-directed (no therapist input) was NOT the best way for those with severe tinnitus distress - THI category 4 (58-76%) and 5 (78-100%) - to benefit. The majority of users (52% of all those registered) had THI scores in excess of 58% THI score tinnitus distress. These findings are similar to those in other self-help health fields.
After running pilot projects with Tinnitus E-Programme (TEP) users from October 2017 to July 2018 incorporating therapist input (from me) during the 6 Module Tinnitus E-Programme, everyone - without exception - who engaged, completed the course successfully. In addition, with therapist input of CBT (Cognitive Behavioural Therapy) training for those needing this additional element of Tinnitus Management, the evidence clearly pointed to the need for therapist input in addition to the course materials themselves.
Clinical Outcomes for both sets of TEP users were as good as the outcomes achieved by patients attending my clinic. This too matches findings in recent published research.