Implementing Cognitive-Behavioral Therapy for People With Psychosis: Local and National Initiatives in the United Kingdom

Objective Although tinnitus is one of the most commonly reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related to accessibility of care and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence-based interventions are necessary. Internet-based cognitive behavioral therapy (ICBT) demonstrates potential as a means of delivering this support but is not currently available in the United States. This article discusses the adaptation of an ICBT intervention, originally used in Sweden, Germany, and the United Kingdom, for delivery in the United States. The aim of this study was to (a) modify the web platform's features to suit a U.S. population, (b) adapt its functionality to comply with regulatory aspects, and (c) evaluate the credibility and acceptability of the ICBT intervention from the perspective of health care professionals and patients with bothersome tinnitus. Materials/Method Initially, the iTerapi ePlatform developed in Sweden was adopted for use in the United States. Functional adaptations followed to ensure that the platform's functional and security features complied with both institutional and governmental regulations and that it was suitable for a U.S. population. Following these adaptations, credibility and acceptance of the materials were evaluated by both health care professionals ( n = 11) and patients with bothersome tinnitus ( n = 8). Results Software safety and compliance regulatory assessments were met. Health care professionals and patients reported favorable acceptance and satisfaction ratings regarding the content, suitability, presentation, usability, and exercises provided in the ICBT platform. Modifications to the features and functionality of the platform were made according to user feedback. Conclusions Ensuring that the ePlatform employed the appropriate features and functionalities for the intended population was essential to developing the Internet-based interventions. The favorable user evaluations indicated that the intervention materials were appropriate for the tinnitus population in the United States.

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Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy for Tinnitus and Hyperacusis Rehabilitation: Outcomes for Patients Treated in Routine Practice

American Journal of Audiology ◽

10.1044/2018_aja-17-0096 ◽

2018 ◽

Vol 27 (4) ◽

pp. 547-558 ◽

Cited By ~ 14

Author(s):

Hashir Aazh ◽

Brian C. J. Moore

Keyword(s):

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Severity Index ◽

Self Report ◽

Cognitive Behavioral ◽

Routine Practice ◽

Rehabilitation Outcomes ◽

The United Kingdom ◽

Before And After ◽

Severity Index Score

Objective The aim was to assess the effectiveness of cognitive behavioral therapy (CBT) for tinnitus and/or hyperacusis delivered by audiologists working in the National Health Service in the United Kingdom. Design This was a retrospective study, based on questionnaires assessing tinnitus and hyperacusis and insomnia before and after CBT. Study Sample Data were gathered for 68 consecutive patients (average age = 52.5 years) who enrolled for CBT. Results All measures showed significant improvements after CBT. Effect sizes for patients who completed CBT were 1.13 for Tinnitus Handicap Inventory scores; 0.76 for Hyperacusis Questionnaire scores; 0.71, 0.95, and 0.93 for tinnitus loudness, annoyance, and effect on life, respectively, measured using the Visual Analog Scale; and 0.94 for the Insomnia Severity Index score. An analysis including those who dropped out also showed significant improvements for all measures. Conclusion Audiologist-delivered CBT led to significant improvements in self-report measures of tinnitus and hyperacusis handicap and insomnia. The methods described here may be used when designing future randomized controlled trials of efficacy.

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