title: Cognitive-behavioral treatments for tinnitus: a review of the literature.
abstract: BACKGROUND
  Tinnitus can be defined as the perception of an auditory sensation, perceivable without the presence of an external sound.
  
  
  OBJECTIVE
  The aim of this article is to systematically review the peer-reviewed literature on treatment approaches for tinnitus based on cognitive-behavioral therapy (CBT) and to provide a historical overview of developments within these approaches.
  
  
  METHODS
  Experimental studies, (randomized) trials, follow-up assessments, and reviews assessing educational, counseling, psychological, and CBT treatment approaches were identified as a result of an electronic database metasearch.
  
  
  RESULTS
  A total of 31 (of the initial 75 studies) were included in the review. Results confirm that CBT treatment for tinnitus management is the most evidence-based treatment option so far. Though studied protocols are diverse and are usually a combination of different treatment elements, and tinnitus diagnostics and outcome assessments vary over investigations, a common ground of therapeutic elements was established, and evidence was found to be robust enough to guide clinical practice.
  
  
  CONCLUSIONS
  Treatment strategy might best be CBT-based, moving toward a more multidisciplinary approach. There is room for the involvement of different disciplines, using a stepped-care approach. This may provide brief and effective treatment for a larger group of tinnitus patients, and additional treatment steps can be provided for those suffering on a more severe level.
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, the Netherlands; Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.
authors.forename: Rilana F F
authors.initials: RF
authors.lastname: Cima
authors.affiliation: Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institute, Stockholm, Sweden.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.affiliation: Psychology Service, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, CT.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Schmidt
authors.affiliation: VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), VA Medical Center, Portland, OR; Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, OR.
authors.forename: James A
authors.initials: JA
authors.lastname: Henry
mesh_terms: D000161:Acoustic Stimulation; D000223:Adaptation, Psychological; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000639:trends; D055317:Evidence-Based Practice; D006801:Humans; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D010470:Perceptual Masking; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D014012:Tinnitus / Q000150:complications / Q000523:psychology / Q000628:therapy*