Mainz, Germany — A German-Swedish study shows that Internet-based self-help training for patients with moderate to severe tinnitus is as successful as group therapy.
The outcome of both the Internet-based therapy and group therapy sessions was significantly better than that of a control group that only participated in an on-line discussion forum, and thus demonstrated that both of the former methods were effective in managing the symptoms of irritating ringing in the ears.
The study was conducted by the Clinical Psychology and Psychotherapy division of the Institute of Psychology at Johannes Gutenberg University Mainz (JGU), and the Department of Behavioral Sciences and Learning at Linköping University in Sweden.
According to the German Tinnitus League (Deutsche Tinnitus-Liga, DTL), 2% of the population suffer from moderate to severe tinnitus, and symptoms of tinnitus can be successfully managed through cognitive behavioral therapy. However, not everyone has the opportunity or the desire to take a course of psychotherapy.
The results of the German-Swedish study show that those affected by tinnitus can now achieve the same level of outcome with the help of an Internet-based therapy program, which encourages them to adopt individual and active strategies to combat their tinnitus. For the purposes of the study, the training program developed in Sweden was adapted so that it could be used for German patients and then be evaluated for its effectiveness.
The study showed that distress measured using the Tinnitus Handicap Inventory was reduced on average from moderate (40 points) to mild (29 points) in participants who completed the Internet-based training course. The results for subjects in the cognitive behavioral therapy group were also very good, with distress levels being reduced from 44 to 29 points. In contrast, there was hardly any change in the control group subjects participating in the online discussion forum. Their average distress level was 40 points at the beginning of the study and remained at 37 points thereafter.
"Our Internet-based therapy concept was very effective when it came to the reduction of tinnitus-related distress or, to put it another way, at increasing the tolerance levels of subjects with regard to their tinnitus," concludes Dr Maria Kleinstäuber of the Clinical Psychology and Psychotherapy division at JGU.
The researchers also saw an interesting result in regard to the patients’ preferred method of therapy. A significant number of subjects were initially skeptical with regard to the Internet-based therapy concept and expressed a preference for group therapy. However, these patients were randomly assigned to the groups. To the researchers’ surprise, after completing the treatment, there was no difference in the effectiveness of the two strategies.
"This means that the Internet-based therapy concept produced as positive a result as group therapy, despite the initial skepticism," says Kleinstäuber. Initial evaluations indicate that the effects of both therapy forms were still persisting after 6 months.
The authors of the study propose that Internet-based forms of therapy should be increasingly used in the psychotherapeutic treatment of tinnitus patients. Furthermore, they call for additional research on patients’ skepticism of Internet-based therapy, particularly in view of the long waiting times and the lack of outpatient forms of therapy.