Audiologist-delivered Cognitive Behavioral Therapy (CBT) for Tinnitus, Hyperacusis, and Misophonia


Tinnitus is the sensation of sound without any external source. Sound intolerance can be divided into hyperacusis, misophonia and noise sensitivity. Hyperacusis is the perception of certain everyday sounds, such as kitchen noises, bangs, and music, as too loud or painful. Misophonia is the perception of certain sounds produced by humans or animals, such as eating and breathing noises, as disgusting, offensive or annoying. On the other hand, noise sensitivity is a personality trait involving underlying attitudes towards noise in general. A person with high noise sensitivity may perceive noise caused by neighbors, nearby factories, workshops, and air conditioning as disruptive and distressing.


The focus of this talk is on audiologist-delivered Cognitive behavioral therapy (CBT) as a part of a specialized rehabilitation program for the management of tinnitus, hyperacusis and misophonia [1-3]. The therapy comprises 14 1-2-1 sessions (via video calls) and spans four stages: I) Assessment, II) Preparation, III) Active treatment, and IV) Maintenance stage.


The content of the therapy briefly comprises:

  1. Education about tinnitus, hyperacusis and misophonia and the relevance of CBT.
  2. Enhancing the patient’s motivation to engage with the therapy process.
  3. Setting goals.
  4. Formulation.
  5. Identifying troublesome thoughts.
  6. Identifying avoidance behaviors and rituals.
  7. SEL (Stop Avoidance, Exposure, & Learn from it).
  8. KKIS (Know, Keep on, Identify, Substitute).
  9. Identify and challenge deeper thoughts and beliefs.
  10. Integrating CBT into a lifestyle (CBStyle).


Learning Objectives:

After this eSeminar, the participants will be able to:

  • Differentiate between tinnitus and tinnitus disorder.
  • Differentiate different types of sound sensitivity: hyperacusis, misophonia and noise sensitivity.
  • Describe the long-term aims of CBT for tinnitus and sound intolerance rehabilitation.
  • Describe stages of CBT treatment
  • Critically analyze the relevance and effectiveness of CBT based on the patient’s characteristics.


Nov 20, 2023, 11:00 AM - 12:00 PM EST


Instructor: Dr. Hashir Aazh PhD with NATUS Hearing and Balance Academy