TY - JOUR
T1 - The tinnitus retraining therapy counseling protocol as implemented in the tinnitus retraining therapy trial
AU - Gold, Susan L.
AU - Formby, Craig
AU - Scherer, Roberta W.
N1 - Funding Information:
The Tinnitus Retraining Therapy Trial (TRTT) project and the preparation of this clinical focus article were supported by National Institute on Deafness and Other Communication Disorders Grants U01DC007411, awarded to C. Formby (TRTT Study Chair), and U01DC007422, awarded to R. W. Scherer (Director of the Data Coordinating Center). The views expressed in this report are those of the named authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of the Air Force, Department of Defense, or the United States Government. This work was prepared as part of official duties performed by the military service members and civilian employees participating in the TRTT project. Title 17 U.S.C. 105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person’s official duties. We gratefully acknowledge the guidance and support of the late National Institute on Deafness and Other Communication Disorders project officer Gordon Hughes and the efforts of the military personnel who comprised the Tinnitus Retraining Therapy Trial Research Group. Their names and respective affiliations are published in the summary report of the TRTT outcomes (Scherer & Formby, 2019). We also gratefully acknowledge the contribution of the volunteer participants in the trial, without whom the TRTT would not have been possible.
Funding Information:
The Tinnitus Retraining Therapy Trial (TRTT) project and the preparation of this clinical focus article were supported by National Institute on Deafness and Other Communication Disorders Grants U01DC007411, awarded to C. Formby (TRTT Study Chair), and U01DC007422, awarded to R. W. Scherer (Director of the Data Coordinating Center). The views expressed in this report are those of the named authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of the Air Force, Department of Defense, or the United States Government. This work was prepared as part of official duties performed by the military service members and civilian employees participating in the TRTT project. Title 17 U.S.C. 105 provides that ?Copyright protection under this title is not available for any work of the United States Government.? Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person?s official duties. We gratefully acknowledge the guidance and support of the late National Institute on Deafness and Other Communication Disorders project officer Gordon Hughes and the efforts of the military personnel who comprised the Tinnitus Retraining Therapy Trial Research Group. Their names and respective affiliations are published in the summary report of the TRTT outcomes (Scherer & Formby, 2019). We also gratefully acknowledge the contribution of the volunteer participants in the trial, without whom the TRTT would not have been possible.
Publisher Copyright:
© 2020 American Speech-Language-Hearing Association.
PY - 2021/3
Y1 - 2021/3
N2 - Purpose: This clinical focus article is a companion to the work of Erdman et al. (2019), in which we described the rationale, development, and implementation of the standard-of-care protocol used in the Tinnitus Retraining Therapy Trial (TRTT), a multicenter, placebo-controlled, randomized, definitive efficacy trial of tinnitus retraining therapy (TRT). We now describe the historical background, development, and standardized implementation and delivery of the TRT counseling protocol (tinnitus counseling [TC]) used in the TRTT. TC is conjectured to be the key component in the TRT protocol for initiating the habituation process that reduces the response to the tinnitus signal and, ultimately, reduces its impact. In the TRTT, participants assigned to receive TC achieved > 30% reduction in the impact of tinnitus. Method and Results: The design and implementation of standardized treatments in multisite randomized controlled trials presents many challenges for investigators. Here, subsequent to presenting the background, rationale, and the TRT protocol model, we describe the development, refinement, and training/certification for standardized delivery of TC in the TRTT. The primary challenges encountered while distilling and streamlining TC for standardized delivery across multiple clinicians and their replacements at six participating military treatment centers in the TRTT are considered, and the resulting counseling protocol is detailed. Conclusions: The standardized and streamlined TC used in the TRTT was successful for treating debilitating tinnitus among persons with functionally adequate unaided hearing sensitivity. The structured TC protocol described here appears to be the main determinant of the significant and sizable TRT treatment effects measured in the TRTT, thus bolstering the merits of this standardized counseling approach as one model for the clinical implementation of TRT for the treatment of primary tinnitus.
AB - Purpose: This clinical focus article is a companion to the work of Erdman et al. (2019), in which we described the rationale, development, and implementation of the standard-of-care protocol used in the Tinnitus Retraining Therapy Trial (TRTT), a multicenter, placebo-controlled, randomized, definitive efficacy trial of tinnitus retraining therapy (TRT). We now describe the historical background, development, and standardized implementation and delivery of the TRT counseling protocol (tinnitus counseling [TC]) used in the TRTT. TC is conjectured to be the key component in the TRT protocol for initiating the habituation process that reduces the response to the tinnitus signal and, ultimately, reduces its impact. In the TRTT, participants assigned to receive TC achieved > 30% reduction in the impact of tinnitus. Method and Results: The design and implementation of standardized treatments in multisite randomized controlled trials presents many challenges for investigators. Here, subsequent to presenting the background, rationale, and the TRT protocol model, we describe the development, refinement, and training/certification for standardized delivery of TC in the TRTT. The primary challenges encountered while distilling and streamlining TC for standardized delivery across multiple clinicians and their replacements at six participating military treatment centers in the TRTT are considered, and the resulting counseling protocol is detailed. Conclusions: The standardized and streamlined TC used in the TRTT was successful for treating debilitating tinnitus among persons with functionally adequate unaided hearing sensitivity. The structured TC protocol described here appears to be the main determinant of the significant and sizable TRT treatment effects measured in the TRTT, thus bolstering the merits of this standardized counseling approach as one model for the clinical implementation of TRT for the treatment of primary tinnitus.
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U2 - 10.1044/2020_AJA-20-00024
DO - 10.1044/2020_AJA-20-00024
M3 - Article
C2 - 33259725
AN - SCOPUS:85102909032
SN - 1059-0889
VL - 30
SP - 1
EP - 15
JO - American Journal of Audiology
JF - American Journal of Audiology
IS - 1
ER -