Tinnitus (i.e., ringing in the ears) is currently the most prevalent service-connected disability i the VA system. A range of clinical interventions has been created to systematically address the range of issues caused by tinnitus. While numerous interventions purport to promote coping strategies for tinnitus-related problems, few studies directly target and measure coping outcomes. Coping strategies are cognitive, affective, and behavioral attempts to master new events, such as the onset of a disability or an impairment like tinnitus, that are overwhelming to an individual, and that because of their newness, an individual does not necessarily have automatic, adaptive responses (Inglehart, 1991; Lazarus & Folkman, 1984; Livneh, 2000). The present study proposes a comparison of a Coping Effectiveness Training (CET) intervention to the standard practice of cognitive-behavioral therapy (CBT) that is used in the Progressive Tinnitus Management (PTM) program, or to a wait-list control. Evidence suggests that CET is effective in facilitating adaptive coping strategies among individuals with several types of impairments or disabilities (Chesney et al., 2003; Chesney, Folkman, & Chambers, 1996; Kennedy, Duff, Evans, & Beedie, 2003; King, & Kennedy, 1999). The proposed study will be the first application of CET to a tinnitus population. The primary goals of this study are to develop CET protocol for the tinnitus population and to evaluate the effectiveness of a CET versus a CBT intervention or a wait-list control, in the context of the PTM program. The long-term goal of this study is to improve the quality of life among Veterans.
The aims of this research are to: 1) develop a CET protocol for Veterans with tinnitus by means of information gathered from two focus groups and from CET consultants; 2) to examine whether a 3-session CET group is as effective or more effective than a 3-session CBT group intervention or wait-list control in increasing adaptive coping strategies among Veterans with tinnitus. Over the course of two years of this pilot study, it is planned that 20 individuals with bothersome tinnitus will participte in a focus group in phase one, and 60 individuals with bothersome tinnitus will be recruited into this study and randomized into two treatment groups or the wait-list control in phase two. These individuals will be at least 18 years of age, will be Veterans, and will include women and minorities. Candidates must demonstrate that the tinnitus is enough of a problem to warrant the intervention. If potential participants are found eligible, they will then receive two tinnitus education group sessions, after which they will be randomly assigned into one of three groups (CET, CBT, or wait-list control). The results of the proposed pilot study will establish a foundation for further investigating what kind of intervention promotes coping with tinnitus, with the goal of providing professionals involved in auditory rehabilitation with more knowledge about how to help facilitate adaptive coping skills among Veterans with tinnitus. The proposed pilot study has the potential to lead to more effective treatment for individuals with bothersome tinnitus by studying a new application of a known coping intervention to Veterans with tinnitus. The long-term objective of this research is to help inform current clinical practices for Veterans with bothersome tinnitus, as well as help to improve the quality of life for individuals with tinnius.
Tinnitus (i.e., ringing in the ears) is currently the most prevalent disability among Veterans. A range of clinical interventions has been created to systematically address the range of issues caused by tinnitus. While numerous interventions purport to promote coping strategies for tinnitus-related problems, few studies directly target and measure coping outcomes. The present pilot study proposes a comparison of a Coping Effectiveness Training (CET) intervention to a cognitive-behavioral therapy (CBT) intervention or a wait-list control group, in the context of the Progressive Tinnitus Management program. The proposed study will be the first application of CET to tinnitus. The primary goals of this study are to develop a CET protocol for tinnitus and to evaluate the effectiveness of a CET versus a CBT intervention or a wait-list control group. The long-term goal of this study is to improve the quality of life among Veterans.
