title: A randomized controlled trial of Internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus.
abstract: OBJECTIVE
  Our aim in this randomized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments, acceptance and commitment therapy (ACT) and cognitive behavior therapy (CBT), in guided self-help format.
  
  
  METHODS
  Ninety-nine participants (mean age = 48.5 years; 43% female) who were significantly distressed by tinnitus were recruited from the community. Participants were randomly assigned to CBT (n = 32), ACT (n = 35), or a control condition (monitored Internet discussion forum; n = 32), and they were assessed with standardized self-report measures (Tinnitus Handicap Inventory; Hospital Anxiety and Depression Scale; Quality of Life Inventory; Perceived Stress Scale; Tinnitus Acceptance Questionnaire) at pre-, posttreatment (8 weeks), and 1-year follow-up.
  
  
  RESULTS
  Mixed-effects linear regression analysis of all randomized participants showed significant effects on the primary outcome (Tinnitus Handicap Inventory) for CBT and for ACT compared with control at posttreatment (95% CI [-17.03, -2.94], d = 0.70, and 95% CI [-16.29, -2.53], d = 0.68, respectively). Within-group effects were substantial from pretreatment through 1-year-follow-up for both treatments (95% CI [-44.65, -20.45], d = 1.34), with no significant difference between treatments (95% CI [-14.87, 11.21], d = 0.16).
  
  
  CONCLUSIONS
  Acceptance-based procedures may be a viable alternative to traditional CBT techniques in the management of tinnitus. The Internet can improve access to psychological interventions for tinnitus.
authors.affiliation: Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden. hugo.hesser@liu.se
authors.forename: Hugo
authors.initials: H
authors.lastname: Hesser
authors.forename: Tore
authors.initials: T
authors.lastname: Gustafsson
authors.forename: Charlotte
authors.initials: C
authors.lastname: Lundén
authors.forename: Oskar
authors.initials: O
authors.lastname: Henrikson
authors.forename: Kidjan
authors.initials: K
authors.lastname: Fattahi
authors.forename: Erik
authors.initials: E
authors.lastname: Johnsson
authors.forename: Vendela
authors.initials: V
authors.lastname: Zetterqvist Westin
authors.forename: Per
authors.initials: P
authors.lastname: Carlbring
authors.forename: Elina
authors.initials: E
authors.lastname: Mäki-Torkko
authors.forename: Viktor
authors.initials: V
authors.lastname: Kaldo
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D019114:Remote Consultation / Q000379:methods*; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome