Tinnitus Management Services

By Tinnitus Specialist – Louise Hart.

Tinnitus affects each individual differently. Some people will need only one appointment to help them with understanding their tinnitus and how to manage it. Other people may need between 3-6 appointments in order to move forward with getting their tinnitus under control.  If you need more than one appointment we will discuss together the length of time between appointments (for example 1 or 2 weeks or more) that best suits you and your tinnitus.

Session 1 ( 1 ½ hrs) Initial Assessment

At your first appointment we will explore your tinnitus/Hyperacusis, we will ask about your medical history. We will review a tinnitus and/or hyperacusis questionnaire and a visual scale that rates the loudness and the effect on your life. These questionnaires will help us understand in what ways the tinnitus is impacting your life.  We may during the appointment use some other questionnaires too if we feel that the tinnitus is impacting your sleep or causing depression and anxiety.

  • We will help you with understanding of your tinnitus, try and understand why it started, why it is affecting you the way it does. We will discuss various methods we could use to reduce your tinnitus
  • Discuss the effect of stress, health and mental health on your tinnitus
  • We may look at stress management techniques, sound enrichment, exercise, relaxation techniques, sleep management
  • Develop cognitive behavioural management strategies for you to manage your tinnitus/hyperacusis distress
  • If  needed we will discuss with you referral to other NHS or private professionals if we think this will help you to move forward such as talking therapies
  • If we are doing a face to face appointment we may  discuss testing your hearing- to understand whether part of the impact of tinnitus is related to a hearing problem and discuss what this means for you and your tinnitus
  • With your permission send a report to GP about appointment results, therapeutic pathway and any onwards referrals needed
  • Discuss with you whether further therapy is required and plan the sessions

Session 2 (45 min) Review  your understanding of what was discussed at your previous appt, and work with you to target and challenge  your troublesome tinnitus

  • Discuss your thoughts about the tinnitus and whether you have noticed any changes after initial assessment.
  • Clarify any points you are unsure of, this is important to ensure that you not going down the wrong path and monitoring your tinnitus
  • Reinforce and help you support any positive changes
  • Target and challenge troublesome thoughts related to your tinnitus
  • Reflect again on the impacts of stress etc. on your tinnitus and how to manage them
  • Reflect with you whether you need additional support from talking therapies (IAPT), or other professionals
  • Give you some homework to do

Session 3 (45 min) Review and reflect on how your tinnitus management techniques are working.

  • Reviewing and reflecting on the outcomes of your homework and any other management techniques being used
  • Reflect on how you are managing, use of other sound enrichment techniques
  • Creation of counterstatements to challenge your negative thoughts related to your tinnitus and a diary of thoughts and feelings (DTF)
  • Reflect with you whether you need additional support from talking therapies (IAPT), or other professionals
  • Repeat your tinnitus questionnaires to see if there has been an improvement.
  • If there is significant improvement in your questionnaire responses then we discuss discharging you.
  • Remember you will have lots of techniques and other skills ( a toolkit so to speak) that you can use and adapt and this will help you know that you can manage use to help you manage your tinnitus not just now but in the future too.

Session 4 /5/6 (45 min) Review and reflections of your homework and where you are with your tinnitus

  • Discuss the cognitive behavioural techniques we have been using your homework
  • Discuss, appraise and modify the thoughts that are responsible for maintaining your tinnitus/hyperacusis distress
  • Develop acceptance of tinnitus and hyperacusis as a condition you can manage
  • Redo your tinnitus questionnaires to see if there has been an improvement.
  • If there is significant improvement in your questionnaire responses then we discuss discharging you.
  • Remember you will have lots of techniques and other skills ( a toolkit so to speak) that you can use and adapt and this will help you know that you can manage use to help you manage your tinnitus not just now but in the future too.

On occasions people will want to book in for single support/refresher appointments, many months or years later. It can be helpful for you to know that support is there if you need it, sometimes a reminder that you are on the right path and a few additional directions may be all that you need to continue to help you manage your tinnitus.