9781638536864

9781684201716

The quintessential clinical guide for audiologists on tinnitus and hyperacusis patient management Since publication of the first edition in 2005, new developments have impacted the treatment paradigm for tinnitus, such as sensory meditation and mindfulness. Tinnitus Treatment: Clinical Protocols, Second Edition, by world-renowned tinnitus experts and distinguished authors Richard S. Tyler and Ann Perreau provides comprehensive background information, up-to-date strategies, essential tools, and online supplementary materials grounded in years of clinical experience and research. It fills a gap in graduate education and available materials to empower audiologists to effectively treat patients suffering from bothersome to severely debilitating symptoms associated with tinnitus or hyperacusis. The textbook includes 15 chapters, starting with three chapters on tinnitus models, treatment approaches, and self-treatment options. The next three chapters summarize counseling approaches for audiologists and psychologists, including introduction of the three-track psychological counseling program for managing tinnitus. Chapters 7 and 8 discuss the use of hearing aids in patients with hearing loss-related tinnitus and sound therapy using wearable devices. Chapter 9 covers smartphone apps for tinnitus assessment, management, and education and wellness, including discussion of limitations. The last six chapters provide guidance on tinnitus management topics including treating children, implementing outcome measures, hyperacusis treatment, and future directions. Key Features New relaxation/distraction tactics including meditation, mindfulness, guided imagery, biofeedback, progressive muscle relaxation, art and music therapy, exercise, and exploration of new hobbies Treatment guidance for patients with tinnitus associated with Meniere's disease, vestibular

schwannoma, unilateral sudden sensorineural hearing loss, and middle ear myoclonus Discussion and research-based evidence covering Internet-delivered self-help treatment strategies New supplemental videos, brochures, handouts, questionnaires, and datasheets enhance knowledge, scope of practice, and incorporation of effective approaches into clinical practice This is a must-have resource for every audiology student and advanced courses, as well as essential reading for all audiologists who feel underprepared in managing tinnitus and/or hyperacusis.

Tinnitus Treatment: Clinical Protocols

MedOne Access Information

Title Page

Copyright

Contents

Videos

Foreword

Preface

Acknowledgments

Contributors

1 Neurophysiological Models, Psychological Models, and Treatments for Tinnitus

1.1 What Is Tinnitus?

1.2 Neurophysiological Models of Tinnitus

1.3 Psychological Models of Tinnitus

1.4 Categories of Tinnitus Treatments

1.5 Counseling in the Treatment of Tinnitus

1.5.1 Be Supportive

1.5.2 Provide Information

1.5.3 Components of Counseling

1.5.4 Examples of Counseling Treatment Protocols

1.6 Sound Therapies for Treating Patients' Reactions to Tinnitus

1.6.1 Counseling for Sound Therapies

1.6.2 Use of Hearing Aids

1.6.3 Music Therapy

1.6.4 Hyperacusis

1.7 Obstacles to Tinnitus Treatment

1.7.1 Negative Beliefs by Clinicians or Patients

1.8 Conclusion

Appendix 1.1 Tinnitus

2 Treating Tinnitus in Patients with Otologic Conditions

2.1 Treating Tinnitus in Patients with Meniere's Disease

2.1.1 Treatment Protocol

2.2 Treating Tinnitus in Patientswith a Vestibular Schwannoma

2.2.1 Treatment Protocols

2.3 Treating Tinnitus in Patients with Unilateral Sudden Sensorineural Hearing Loss

2.3.1 Early Intervention

2.3.2 Information Regarding Mechanisms

2.3.3 Hearing Therapy

2.3.4 Treating Tinnitus Associated with Middle Ear Myoclonus

2.4 Other Relevant Conditions

2.5 Conclusion

3 Internet-Delivered Guided Self-Help Treatments for Tinnitus

3.1 Background

3.1.1 Tinnitus and Self-Help Material

3.2 Internet-Delivered GuidedSelf-Help

3.2.1 Technical Functionality of the Internet Platform

3.2.2 Conducting Assessments

3.2.3 Theoretical Foundation of the Intervention

3.2.4 The Intervention Content

3.2.5 Supporting Patients

3.2.6 Fostering Adherence.

3.3 Evaluation of Internet-Interventions for Tinnitus and Potential Problems

3.3.1 Effects of the Internet-Based Self-Help for Tinnitus

3.3.2 Problems Related to Dropouts and Compliance

3.3.3 Security and Technical Concerns

3.4 Conclusion

Appendix 3.1 Suggested Self-Help Resources for Tinnitus

Appendix 3.2 Tinnitus Self-Treatment Brochure

4 Tinnitus Activities Treatment

4.1 Introduction

4.1.1 Patient Expectation Nurturing

4.1.2 Picture-Based Counseling

4.1.3 Patient-Centered Approach to Care

4.2 Discussion

4.2.1 Thoughts and Emotions

4.2.2 Hearing and Communication

4.2.3 Sleep

4.2.4 Concentration

4.3 Conclusion

Appendix 4.1 Tinnitus Primary Functions Questionnaire (12-Item Version)

Appendix 4.2 Things You Can Do for Your Tinnitus

Appendix 4.3a Tinnitus Diary

Appendix 4.3b Tinnitus Diary Example Case

Appendix 4.4 Strategies to Improve Hearing and Communication

Appendix 4.5 A Guide to a Good Night's Sleep for Tinnitus Patients

Appendix 4.6 Strategies to Improve Your Sleep

Appendix 4.7 Strategies to Improve Concentration

Appendix 4.8 Daily Listening Diary

5 Three-Track Tinnitus Protocol: Counseling Emphasizing the Patient, the Clinician, and the Alliance

5.1 Introduction

5.2 Protocol

5.2.1 Making the Initial Contact

5.2.2 The First Session: The Contract

5.2.3 Working in the Tracks

5.3 Conclusion

6 The Psychological Management of Tinnitus-Related Insomnia

6.1 Introduction

6.2 The Cognitive Behavioral Model

6.2.1 Cognitive Behavioral Therapy and Insomnia

6.2.2 The CB Model, Tinnitus, and Sleep

6.3 Group Therapy

6.4 Selection and Definitions

6.5 Assessment

6.5.1 Questionnaire Measures

6.5.2 Sleep Diaries

6.6 Group Structure

6.7 Treatment Protocol: Key Components

6.7.1 Group Support

6.7.2 Psychoeducation.

6.7.3 Individual Goal Setting

6.7.4 Creating an Individualized Sleep Program

6.7.5 Sleep Titration

6.7.6 Stimulus Control

6.7.7 Motivation and Video Modeling

6.7.8 Relaxation

6.7.9 Cognitive Restructuring (Cognitive Therapy)

6.7.10 Worry Period

6.7.11 Sleep Hygiene

6.7.12 Sound Enrichment

6.7.13 ClockWatching

6.8 Conclusion

Appendix 6.1 Relaxation Listening for Sleep

7 Optimizing Hearing Aid Fittings for Tinnitus Management

7.1 Introduction

7.2 Benefits, Modes, and Mechanisms

7.3 Clinic Protocol

7.3.1 Audiometry and Evaluation

7.3.2 Aural Rehabilitation and Goal Setting

7.3.3 Instruction

7.3.4 Counseling

7.3.5 Sensory Management: Selection of Hearing Aids and Their Features

7.3.6 Perceptual Training

7.3.7 Appointment Scheduling and Follow-Up

7.4 Conclusion

8 Combining Sound Therapy with Amplification

8.1 Introduction

8.2 Sound Therapy Framework

8.2.1 The Presence of Sound Effect

8.2.2 The Context of Sound Effect

8.2.3 Reaction to Sound Effect

8.2.4 Adaptation to Sound

8.2.5 WHO International Classification of Functioning, Disability, and Health

8.3 Protocol

8.3.1 Audiometry and Evaluation

8.3.2 Aural Rehabilitation and Goal Setting

8.3.3 Instruction

8.3.4 Counseling

8.3.5 Sensory Management: Selection and Use of Different Sounds

8.3.6 Device Selection and Fitting

8.3.7 Negative Effects

8.3.8 Perceptual Training

8.3.9 Follow-Up

8.3.10 New and Emerging Concepts

8.4 Conclusion

9 The Clinical Relevance of Apps for Tinnitus

9.1 Introduction

9.2 Apps for Tinnitus Assessment and Management

9.2.1 Apps for Education and Information on Tinnitus

9.2.2 Apps for Wellness

9.2.3 Limitations and Risks Associated with Smartphone Apps

9.3 Conclusions.

10 Distractions, Relaxation, and Peace with Tinnitus: Guided Imagery, Meditation, Mindfulness, and More

10.1 Introduction

10.2 Meditation

10.3 Mindfulness

10.4 Guided Imagery

10.5 Biofeedback

10.6 Progressive Muscle Relaxation

10.7 Art Therapy

10.8 Music Therapy

10.9 Exercise

10.10 A New Hobby

10.11 Conclusions

11 Tinnitus in Children

11.1 Introduction

11.2 Prevalence

11.3 Etiology of Tinnitus in Children

11.4 Factors that may Promote Tinnitus in Children

11.4.1 Age

11.4.2 Gender

11.4.3 Hearing Loss

11.4.4 Temporary Threshold Shifts

11.4.5 Motion Sickness

11.4.6 Hyperacusis

11.5 Criteria of Tinnitus in Children

11.6 Impact of Tinnitus on Children and Parents

11.7 Evaluation

11.7.1 History

11.7.2 Physical Examination

11.7.3 Audiological

11.7.4 Laboratory Evaluations

11.7.5 Radiological

11.8 Preventing Tinnitus in Children

11.9 Treatment Options

11.9.1 Medical Treatment

11.9.2 Surgical Treatment

11.9.3 Counseling Treatment for Young Children

11.10 Conclusion

12 Measuring Tinnitus and Reactions to Tinnitus

12.1 Introduction

12.2 Measuring Tinnitus

12.2.1 Psychoacoustic Measurements

12.2.2 Measuring Reactions to Tinnitus

12.3 Measuring Quality of Life

12.3.1 Measuring Related Problems

12.4 Conclusions

Appendix 12.1 Data Sheet

Appendix 12.2 Tinnitus Handicap Questionnaire

Appendix 12.3 Tinnitus Intake Questionnaire

Appendix 12.4 Meaning of Life and Happiness Questionnaire

Appendix 12.5 Ordered References for Tinnitus Outcome Measures

13 Hyperacusis

13.1 Introduction

13.2 Terminology

13.3 Causes

13.4 Mechanisms

13.5 Measuring Hyperacusis

13.6 Questionnaires

13.7 Treatments

13.7.1 Counseling-Hyperacusis Activity Treatment

13.7.2 Introduction

13.7.3 Thoughts and Emotions.

13.7.4 Hearing and Communication

13.7.5 Sleep

13.7.6 Concentration

13.7.7 Hearing Protection

13.7.8 Sound Therapies

13.7.9 Using Hearing Aids to Help with Hyperacusis

13.8 Conclusion

Appendix 13.1 Hyperacusis Problems Questionnaire

Appendix 13.2 Hyperacusis Intake Questionnaire

Appendix 13.3 Hyperacusis Disability and Handicap Scales

Appendix 13.4 Life too Loud? Let's Talk Hyperacusis

Appendix 13.5 Hyperacusis Activities Treatment

Appendix 13.6 Sound Therapy Treatment Protocol for Hyperacusis

Appendix 13.7 Hyperacusis Listening Diary Example Case

14 Navigating Future Directions in Tinnitus Treatment

14.1 Introduction

14.1.1 What Should a Clinician Tell a Patient About Novel Treatment Methods?

14.2 Neuromodulation-Magnetic Stimulation, Electric Stimulation

14.2.1 What Is Magnetic Neuromodulation?

14.2.2 Magnetic Stimulation and Tinnitus

14.2.3 Caveats

14.2.4 Electric Stimulation

14.2.5 Electric Stimulation and Tinnitus

14.2.6 Caveats

14.3 Vagus Nerve Stimulation

14.3.1 Vagus Nerve Stimulation and Tinnitus

14.3.2 Caveats

14.4 Neurofeedback

14.4.1 Neurofeedback and Tinnitus

14.4.2 Caveats

14.5 Conclusions

15 Establishing a Tinnitus and Hyperacusis Clinic

15.1 Introduction

15.2 Structuring Clinical Services

15.2.1 Group Educational Session

15.2.2 Individual Sessions

15.3 Different Treatment Levels for Different Tinnitus and Hyperacusis Patients

15.3.1 Tinnitus

15.3.2 Hyperacusis

15.4 Billing for Tinnitus Services

15.5 Conclusion

Appendix 15.1 Shared Medical Visit Waiver

Appendix 15.2 Tinnitus Intake Questionnaire

Appendix 15.3 Tinnitus Treatment Fact Sheet

Index

Additional MedOne Access Information.