Attributes of Tinnitus Counselling

Abstract

Counselling plays a role in virtually all treatment strategies available for tinnitus (R. S. Tyler & Baker, 1983). Tinnitus-specific Cognitive Behavioural Therapy (CBT) has been proven to be highly effective at improving tinnitus distress, and quality of life (H.-P. Zenner et al., 2016). However CBT is a prolonged treatment programme, and administered by a psychologist which can be beyond the reach of many people. Because CBT for tinnitus and other tinnitus counselling programmes comprise an umbrella of different techniques, it is difficult to ascertain which attributes of the programme provide benefit or if the results are due to a combined effect (Hesser, Weise, Westin, & Andersson, 2011). Therefore studies which can dismantle the separate components of tinnitus counselling are required. This study investigated whether a one-off counselling intervention was able to help sufferers of distressing/bothersome tinnitus. It also looked at the effects of different attributes of counselling therapy on two groups of participants who had self-reported bothersome tinnitus. The primary purpose of this study however, was qualitative analysis of the counselling process which sought to ascertain the effect of counselling on quality of life, as well as to determine which attributes were of most benefit or otherwise and gain feedback from an individual’s perspective. Both groups underwent the same broad ranging counselling therapy for their tinnitus but one group received an additional reinforcement therapy consisting of a visualisation technique incorporating background sounds, which was designed to be practised on a daily basis for 3 weeks. All the participants completed psychometric questionnaires just prior to the treatment and 3 weeks’ post treatment. These were used for the quantitative portion of the study. For the qualitative analysis, every participant was interviewed 3 weeks’ post treatment and the interview transcripts coded and analysed for common themes. This study found that there was a statistically significant improvement in quality of life measures following the counselling intervention, and more importantly, a clinically meaningful change was recorded in 7 out of the 8 participants. This finding was supported by the personal interviews. The reinforcement therapy showed no significant difference between the groups from the quantitative analysis, but this contrasted with the personal reports of 3 out of the 4 participants who suggested it was of great benefit and would continue to use it in the future. In trying to deconstruct other attributes of the counselling programme, participant feedback suggested that there was no one attribute that was integral, but that benefit was derived from either a combination of the counselling as a whole or from whichever aspects were deemed pertinent. These varied from individual to individual. These results imply that a one-off counselling session can provide benefit to tinnitus sufferers. No firm conclusions can be drawn regarding particular attributes of the tinnitus counselling and further study is required in this area. The visualisation/sounds technique introduced in this study was strongly supported by the majority of the participants, and also warrants further investigation.