Development and Effectiveness of Tinnitus Activities Treatment-Online, a Self-Paced Remote Counseling Program

For many people with bothersome tinnitus, accessing in-person intervention is difficult. We developed a remote counseling program, Tinnitus Activities Treatment-Online (TAT-Online), to provide for patients' tinnitus education and coping strategies. We aimed to test the effectiveness and acceptability of the remote counseling program in adults with tinnitus.

We included adults with chronic tinnitus who had access to a smartphone, tablet, or computer. In total, 59 adult participants completed all study procedures out of 243 adults who were initially enrolled. Participants completed weekly modules that included viewing narrated videos, practicing strategies using homework, and completing quizzes at the end of each session to assess learning. Participants completed the sessions in a self-paced manner over 6 weeks: Week 1: Questionnaires and Introduction; Week 2: Thoughts and Emotions; Week 3: Sleep; Week 4: Hearing; Week 5: Concentration; and Week 6: Relaxation Techniques and Sound Therapy. Participants completed four outcome measures before the remote counseling began in Week 1 and after the remote counseling concluded in Week 6. Statistical analysis was conducted using a doubly multivariate analysis of variance approach. Acceptability of TAT-Online was determined based on an exit survey and compliance in completing the activities.

Comparing pre- to posttest scores, there was a significant improvement on all tinnitus measures and significantly lower ratings of tinnitus loudness and annoyance. There was no significant change in Meaning of Life ratings. Mean ratings of effectiveness for the TAT-Online videos were rated at 9 out of 10. The self-paced format of TAT-Online was acceptable and easy to follow and effective for patients' learning to cope with tinnitus.

Self-paced remote tinnitus counseling, which included asynchronous educational videos, reflection exercises, and helpful strategies, was effective for learning how to cope with tinnitus. In future studies, we plan to conduct a randomized control trial to further investigate the effectiveness of TAT-Online in combination with hearing or tinnitus devices.