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Cognitive Behavioral Therapy for Veterans With Tinnitus

Cognitive behavioral therapy encourages acquisition, practice, and use of a range of specific coping strategies to enhance perceptions of self-control and self-efficacy for patients with tinnitus.
Federal Practitioner. 2018 August;35(8)a:36-46
August 22, 2018|Federal Practitioner
Caroline J. Schmidt, PhD;Robert D. Kerns, PhD;Suzanne Finkel, AuD,;Elias Michaelides, MD;James A. Henry, PhD
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Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.

Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the US Government, or any of its agencies.

Dr. Schmidt is a Clinical and Research Psychologist and Dr. Finkel is a Staff Audiologist, both at the VA Connecticut Healthcare System in West Haven. Dr. Kerns is a Professor in the Departments of Psychiatry, Neurology and Psychology, Dr. Michaelides is an Associate Professor of Otolaryngology and Dr. Schmidt is an Assistant Clinical Professor, all at
Yale School of Medicine. Dr. Henry is a VA RR&D Research Career Scientist with the National Center for Rehabilitative Auditory Research at the VA Portland Health Care System in Oregon, and a Research Professor in the Department of Otolaryngology – Head & Neck Surgery at Oregon Health & Science University in Portland.
Correspondence: Dr. Schmidt (caroline.schmidt@va.gov)

The article has been corrected from the original version.

Conclusion

The qualitative feedback from participants was generally positive for both protocols. Emergent themes confirmed the need for a veteran-specific intervention while highlighting individual veterans’ needs. Transcripts from sessions provided additional descriptive information that identified changes to the protocols that would improve veterans’ receipt of care. Due to the abundance of veterans with tinnitus and the needs of veterans in terms of health care delivery and receipt, an interdisciplinary CBT-plus-AC protocol was created that is specific to and accepted by veterans with tinnitus.

Refinements to the VET CBT-T protocol were identified that led to development of PTM that was the subject of another small study, which then led to the authors’ 2 larger RCTs. Attempts were made to include greater attention to the mental health concerns of veterans both in terms of education and in offering sensitive delivery of the protocol. Session content was used to create an organized, visual presentation that follows an organized workbook.22,35 Refinements to the protocol are ongoing.

Acknowledgments
This material was based on work supported by US Department of Veterans Affairs, Rehabilitation Research and Development (RR&D): (1) R.D. Kerns’ Pilot Merit Grant #C6324P and (2) C.J. (Kendall) Schmidt’s Career Development Award-1 #D6848M. The authors would like to acknowledge the assistance from Rebecca Czlapinski, MA; Kathryn LaChappelle, MPH; and Emily Thielman, MS, for the conduct of the study, data collection and management, and preparation of this manuscript.

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