The CBT for Tinnitus E-Programme is presented in 12 stages. Unlike the original Tinnitus E-Programme that consisted of 6 modules and was suitable for people with up to mid-moderate tinnitus distress (maximum 48% TFI), the 12 stage process is suitable for those with TFI categories 3, 4 and 5. 

Since July 2020 when the 12 stage process was first made available, the content and bespoke tools used have been finely tuned, with some additions: for example, early-on at stages 3 and 4, encouragement to develop a RECOVERY-ORIENTED PERSPECTIVE superseding the commonly experienced PROBLEM-ORIENTED PERSPECTIVE, and Values Based Action from Acceptance & Commitment Therapy (ACT) to benefit more from Goal Setting in stage 5.

The main difference for those starting out in the higher categories 4 and 5, is they need longer at each of the stages, especially after stage 4. Each stage opens for the User exactly one week apart; however, all Users are encouraged to spend longer than one week at any or all of the stages - on average around 10 days at each stage. This is because any process needs to fit the individual using it - it is unrealistic to expect a person to fit a process.

When a patient attends a clinic, their therapist guides them through the process. There is no question of progressing the patient before they are ready - the process is tailored to the individual patient's needs. The daily relaxation logs and Progress Checks at the beginning of each of the first 6 stages of the CBT for Tinnitus E-Programme help to keep Users 'on track'. An additional interaction introduced in August 2023 is the weekly REPORT DAY called the weekly SITREP. The SITREP is proving very popular indeed with Users. Please read about the weekly SITREP here.

The course is a defined process that has become a Neuroscience & CBT Protocol, worked through at a patient’s own pace and used in the order it is set out. There is a reason for everything used being not only what it is, but where it is in the process. Neuro-psychotherapy and associated neuroscience, with cognitive and behaviour therapy are woven in to the process, stage by stage.

The average time taken to complete the process varies widely, ranging from 16 to 28 weeks. Two 1-1 appointments has proven ample for 97% of Users alongside the 12 stage process, the first 1-1 between 4-6 weeks after starting the process, and the second 1-1 often around stages 8 and 9. There is additional time contributed, such as email support and the monitoring of logs, progress checks and interactive tools, but clinician time amounts to a small fraction of the time required when working individually all 1-1. 

DISTRESS

Distress over time leads to over-active Sympathetic Nervous System (SNS) activity and simultaneous suppression of Parasympathetic Nervous System (PNS) activity. Persistent SNS over-activity and PNS suppression perpetuates feelings of distress. This is called Emotional Dysregulation.

The CBT for Tinnitus E-Programme provides the process to regulate the nervous system to the level where the individual is able to address the thinking patterns that perpetuated them.

THINKING PATTERNS ARE HABIT

A habit is brain-based. Although we tend to think of a habit being a behaviour, thoughts are also habitual. Any habit is an established pattern of firing neurons deep within the brain. When a habit is not serving our well being, we need to form a different habit - one that does serve our well being. The more we use the new thinking, the stronger the new firing patterns become, the more the old ones weaken.

Using the CBT for Tinnitus E-Programme, new habits grow through:

  • The 'little and often, regular and consistent' use of breath work and relaxation, the nervous system can regulate AND it forms a HABIT 

  • Identifying the Cognitive Distortions repeatedly used (through HABIT) at Stage 4, and then unpicking them from Stage 5 using reframing, begins to grow new neural firing patterns, creating new habit-thinking 

Common Mistakes

This document highlights the most common mistakes and misunderstandings people have about using the CBT for Tinnitus E-Programme process:
Common Mistakes.pdf 70.94 KB

How the course is presented

The CBT for Tinnitus E-Programme is presented in the same format as this information pack for Advisors (using the Podia platform). View the course on Podia. The link is to the 12 stage course with two 1-1 appointments. By going to https://courses.tinnituseprogram.org the same course but with either one or three 1-1 appointments included can also be viewed.