Internet-Based Cognitive Behavioral Therapy Offers Lasting Relief for Tinnitus
For individuals grappling with the persistent challenge of tinnitus, internet-based cognitive behavioral therapy (ICBT) demonstrates significant and enduring improvements, even up to six years after treatment, according to a study published March 19, 2026, in JAMA Otolaryngology–Head & Neck Surgery.
Understanding the Study
Researchers, led by Eldre Beukes, Ph.D., from Anglia Ruskin University in Cambridge, England, followed participants from a nonrandomized clinical trial to assess the long-term effects of ICBT on tinnitus. The study employed a repeated-measures design, tracking outcomes at six different time points over a six-year period.
Key Findings
Of the original 138 participants, 49 (35.5%) completed the six-year post-intervention assessment. The results revealed sustained improvements associated with ICBT, with minimal variation over the six years and substantial within-group effect sizes at the six-year mark.
While the primary benefit was observed in reducing tinnitus distress, smaller positive effects were also noted in measures of anxiety, depression, insomnia, satisfaction with life, and hyperacusis (increased sensitivity to sound). Approximately 39% of participants experienced clinically significant improvements based on a reliable change index, while 55% met the criteria for a minimal clinically important difference in their Tinnitus Functional Index scores.
The durability of treatment effects extended to tinnitus distress, as well as measures of anxiety, depression, insomnia, and satisfaction with life, though not to auditory-related effects.
Implications for Tinnitus Management
“This is of importance since health care systems continue to struggle to maintain waiting times and have the required resources to manage tinnitus,” the authors wrote. “Ways of integrating them into current care pathways should be considered due to the need for minimal resources, and health and economic benefits.”
Cognitive Behavioral Therapy for Tinnitus: A Deeper Glance
Cognitive behavioral therapy (CBT) is a widely recommended treatment for tinnitus. It focuses on helping individuals redirect negative thoughts and emotions that can exacerbate the perception of tinnitus. But, a study published in August 2024 by JAMA Otolaryngology-Head & Neck Surgery suggests that CBT may be most effective for those with severe symptoms. Researchers found that patients with the most severe tinnitus and related anxiety experienced the greatest reduction in tinnitus severity following eight sessions of CBT.
While CBT can be time-consuming and costly, and may not always be covered by insurance, ICBT offers a more accessible and resource-efficient alternative.
Predictors of CBT Response
Research published in JAMA Otolaryngology-Head & Neck Surgery identifies that high to moderate anxiety levels and severe tinnitus bother are associated with a greater response to CBT. The study, conducted with 88 adult patients, found that these factors were significant predictors of improvement, with adjusted odds ratios of 3.33 for anxiety and 12.08 for tinnitus bother.
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