Cognitive Behavioral Therapy Flashcards
What are the different types of tinnitus management options?
Approaches targeting the tinnitus perception
Approaches targeting the reactions to tinnitus
Combined approaches that target both the perception and reactions to tinnitus
Can thoughts influence emotions?
Yes
Our interpretation of events, rather than the events themselves, significantly influences our emotional responses and psychological well-being
What is cognitive behavioral therapy?
A problem-focused and action-oriented psychological intervention that combines principles from behavioral and cognitive psychology
What is the history behind CBT?
Originated from cognitive therapy, which was developed by psychiatrist Aaron Beck in the 1960s
Created to treat anxiety and depression
What are the ABC’s of CBT?
Activating event
Belief (thought)
Consequence (emotional)
*Created by Ellis and influenced the creation of CBT
*Assumes emotions and behavioral reactions are a result of appraisals of an event and are not a result of the event itself
Did Beck believe that distorted or inaccurate thoughts were prominent features of depression?
Yes
These features could eb targeted in cognitive therapy, which was later expanded to CBT
Today, what is CBT used to treat?
A wide range of mental health challenges (anxiety, PTSD, substance use, sleep disorder, migraines, dementia, and obesity)
What does CBT do today?
Uses a variety of cognitive and behavioral techniques to help individuals identify and modify the relationships between their thoughts, behaviors, and emotions
CBT is based on the basic principle that what we think, how we feel, and how we behave are all closely connected, and each of these factors has a decisive influence on well-being
What are the goals of CBT?
Monitor their negative, automatic thoughts.
Recognize the relationships between thoughts, emotions, and behaviors.
Assess the validity of their distorted automatic thoughts by examining evidence.
Replace biased thoughts with more reality-oriented interpretations.
Identify and modify the dysfunctional beliefs that lead to distorted experiences
What are the 2 main components of CBT?
Cognitive restructuring
Behavioral modification
Why does CBT work for tinnitus?
Due to the relationship between tinnitus and psychological distress
CBT approach to tinnitus is based on a model developed by researchers including Hallam
Most widely used psychological strategies for coping with tinnitus
How can the ABC model apply to tinnitus?
A - tinnitus perception
B - “I cannot live with it” “There is nothing I can do about it” “If I didn’t work in this noisy environment, I wouldn’t have to deal with this”
C - desperation, hopelessness, depressed, anger, etc.
What is the goal of CBT with tinnitus?
Alter than maladaptive cognitive, emotional, and behavioral responses to tinnitus
Not to abolish the tinnitus itself
Address psychological distress
Modify unhelpful thoughts
Address emotional reaction
Help improve quality of life
What are the principles of CBT for tinnitus?
Requires setting specific goals and a defined time for completion (typically between 6 to 10 weeks)
Involves active participation, homework assignments, and strategies for relapse prevention
Aims to promote habituation to tinnitus and prevent dishabituation
Does CBT consist of both cognitive and behavioral strategies?
Yes
Cognitive therapy focuses on altering how one thinks about tinnitus, aiming to reduce negative ideation
Behavioral therapy focuses on using techniques like positive imagery, attention control to divert focus from tinnitus, exposure to stressful situations to lessen their impact, and relaxation training to ease symptoms
What is needed prior to a CBT session?
A medical consultation
Audiological evaluation
Initial meeting involving a structured interview lasting about 1.5 hours (to explore the patient’s tinnitus history, its psychological and physical effects, triggers, and prior treatments)
*want to build a strong therapeutic rapport and determine the patients suitability for psychological treatment
What is relaxation training?
Teaches tension reduction through muscle relaxation exercises
practice begins in comfortable environments and gradually moves to real-life situations, like sitting at a desk or watching television
Relaxation techniques may be helpful in assisting people in learning a way of coping with tension and anxiety related to tinnitus
Limited effectiveness alone; best integrated into a comprehensive tinnitus management program
Does cognitive therapy involve the identification of dysfunctional beliefs and negative thoughts?
Yes
These occur in response to life events or sources of distress
Do tinnitus patients learn to redirect their attention from the tinnitus to environmental details?
Yes
Techniques encourage engaging other senses, like smelling coffee or tasting honey, to distract from tinnitus
Using sound masking or amplifying background noises helps manage tinnitus more effectively
What do imagery techniques do?
Modify negative associations with tinnitus by either “masking” the noises or integrating them into positive scenes
Masking through imagination: imagining their tinnitus sounds being masked by a waterfall or ocean waves
Incorporating into pleasant scenes: imagining certain scenarios such as walking in nature
What are some sleep management techniques that might help with tinnitus?
Sleep hygiene, bedtime and worry-time restriction, relaxation, and cognitive restructuring
What is done to prevent relapse?
Discussing potential risk factors for worsening tinnitus and hearing loss
Create a proactive plan for managing any escalation of symptoms
Identifying Risk Factors
Importance of Continuous Practice
Managing Temporary Fluctuations
Generalization of Treatment Benefits
Post-Treatment Support
Is CBT effective?
Yes
Has the most favorable results of all tinnitus treatments
Proven effective in decreasing tinnitus distress and annoyance, reducing anxiety, and improving daily life functioning
Remains sparsely available and is often one of the least recommended treatment options
Who should provide CBT?
Ideally a trained CBT therapist or psychologist
Reality is that there are very few therapists that are trained in CBT for tinnitus
There is a need to make CBT accessible to a broader multidisciplinary community
Audiologists can apply CBT principles with proper training and supervision, though training programs are limited
Referrals to psychologists or psychiatrists are necessary for patients with severe mental health concerns, but such referrals are rarely made from audiology services
Who benefits from CBT?
Adults aged 40-70 years with or without hearing loss
No severe comorbid psychological conditions
Had tinnitus and/or suffered from tinnitus for at least 3 months
Seeking to alleviate the impact of tinnitus on their quality of life and daily activities
*Based on current research
