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Internet versus group cognitive-behavioral treatment of distress associated with tinnitus: A randomized controlled trial
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University.
Uppsala University.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
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2008 (English)In: Behavior Therapy, ISSN 0005-7894, E-ISSN 1878-1888, Vol. 39, no 4, 348-359 p.Article in journal (Refereed) Published
Abstract [en]

Tinnitus distress can be reduced by means of cognitive-behavior therapy (CBT), and the treatment can be delivered in different ways. The most recent format is Internet-based self-help. The aim of this study was to compare this treatment (n = 26) with standard group-based CBT (n = 25) in a randomized controlled trial. Outcomes on self-report inventories measuring tinnitus distress were evaluated immediately after and 1 year after treatment. Results showed that both groups had improved, and there were few differences between them. The effect size for the Internet treatment was d = 0.73 (95% CI = 0.16-1.30) and for the group treatment was d = 0.64 (95% CI = 0.07-1.21). The Internet treatment consumed less therapist time and was 1.7 times as cost-effective as the group treatment. At pretreatment patients rated the Internet treatment as less credible than the group treatment. In conclusion, Internet treatment for tinnitus distress merits further investigation, as the outcomes achieved are promising.

Place, publisher, year, edition, pages
2008. Vol. 39, no 4, 348-359 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-97347DOI: 10.1016/j.beth.2007.10.003ISI: 000261906400004PubMedID: 19027431OAI: oai:DiVA.org:uu-97347DiVA: diva2:172242
Available from: 2008-05-22 Created: 2008-05-22 Last updated: 2016-04-28Bibliographically approved
In thesis
1. Cognitive Behavioural Therapy as Guided Self-help to Reduce Tinnitus Distress
Open this publication in new window or tab >>Cognitive Behavioural Therapy as Guided Self-help to Reduce Tinnitus Distress
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Tinnitus is common, and some individuals with tinnitus display high levels of distress. Cognitive behavioural therapy (CBT) is effective in reducing tinnitus distress, but is rarely available. CBT-based self-help, with or without guidance, has yielded positive results in other problem areas, and one initial randomized controlled trial (RCT) has shown promising results for tinnitus.

This thesis is based on four studies;

Study I showed that Internet-based self-help treatment with e-mail guidance alleviated tinnitus distress among consecutive patients and was rated as credible as traditional treatments. Active participation in treatment predicted outcome.

Study II, an RCT, showed that an extended and more interactive version of the Internet-based self-help treatment with e-mail therapist support appeared to be equally effective as a group treatment. In study III, another RCT, a self-help book with weekly telephone support was superior to a wait-list control group. No strong evidence for the importance of telephone contact on outcome was found. In both study II and III, the positive outcome remained after one year and self-help approaches appeared more therapist time-effective compared to group treatment. Also, the received treatment-dose for patients in guided self-help was not lower than in the group treatment.

Study IV found that the ‘Stages of Change’, from the transtheoretical model, are probably not the right theoretical framework to use with tinnitus patients. Predictors of outcome were found, but they were not in line with the theory behind the Stages of Change. The predictors were better understood when conceptualized as coping, showing that helplessness and less coping before treatment correlated with better outcome.

In sum, guided cognitive behavioural self-help can decrease tinnitus distress. It appears to be therapist time-effective and shows effects comparable to or slightly below traditional CBT for tinnitus. Effects remain one year after treatment and generalize to a routine clinical setting.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. viii, 89 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 40
Psychology, Tinnitus, Cognitive Behavioural Therapy, Self-help, Internet, Stages of Change, Psykologi
urn:nbn:se:uu:diva-8927 (URN)978-91-554-7235-1 (ISBN)
Public defence
2008-06-13, Sal IX, Universitetshuset, Uppsala, 13:15
Available from: 2008-05-22 Created: 2008-05-22Bibliographically approved

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Buhrman, Monica
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Department of PsychologyUppsala UniversityDepartment of Surgical Sciences
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