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Randomized Controlled Trial in Clinical Settings to Evaluate Effectiveness of Coping Skills Education Used With
James A Henry1, Emily J Thielman2, Tara L Zaugg2
1Veterans Affairs Rehabilitation Research and Development National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, ORDepartment of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland.
Purpose:
This randomized controlled trial evaluated, within clinical settings, the effectiveness of coping skills education that is provided with progressive tinnitus management (PTM).
Method:
At 2 Veterans Affairs medical centers, N = 300 veterans were randomized to either PTM intervention or 6-month wait-list control. The PTM intervention involved 5 group workshops: 2 led by an audiologist (teaching how to use sound as therapy) and 3 by a psychologist (teaching coping skills derived from cognitive behavioral therapy). It was hypothesized that PTM would be more effective than wait-list control in reducing functional effects of tinnitus and that there would be no differences in effectiveness between sites.
Results:
At both sites, a statistically significant improvement in mean Tinnitus Functional Index scores was seen at 6 months for the PTM group. Combined data across sites revealed a statistically significant improvement in Tinnitus Functional Index relative to wait-list control. The effect size for PTM using the Tinnitus Functional Index was 0.36 (small).
Conclusions:
Results suggest that PTM is effective at reducing tinnitus-related functional distress in clinical settings. Although effect sizes were small, they provide evidence of clinical effectiveness of PTM in the absence of stringent research-related inclusion criteria and with a relatively small number of sessions of cognitive behavioral therapy.