Stepped-Care CBT Treatment from the University of Maastricht

Discussion in 'Treatments' started by jacob21, Feb 23, 2019.

    1. jacob21
      Amazed

      jacob21 Member Benefactor

      Tinnitus Since:
      2008 > 2009 "cured" >2nd onset June 2016
      Cause of Tinnitus:
      Noise Induce ( loud music )
      Original article in Dutch:
      https://www.rtlnieuws.nl/nieuws/ned...ndelmethode-tinnitus-patienten-willen-na-deze

      Google Translate into English:
      https://translate.google.com/transl...ndelmethode-tinnitus-patienten-willen-na-deze

      The treatment consists of CBT administered by a multidisciplinary team of healthcare professionals. The first step entails a combination of audiological and psychological treatment, which is then supplemented (if needed) by movement therapy, physical therapy and support from a social worker.
       
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    2. Bob den Hartog

      Bob den Hartog Member

      Tinnitus Since:
      11/2018
      Cause of Tinnitus:
      Noice induced
      What I’m getting from the article is basically, get used to the sound by focusing on it. Basically what I’m forced to do anyway, since I can’t mask it. Also, it’s not exactly new, but apparently they are going to make it the standard treatment here in the Netherlands. Let’s hope it won’t prevent them from introducing the Neuromod...
       
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    3. gadsie
      Angelic

      gadsie Member

      Tinnitus Since:
      2016
      Cause of Tinnitus:
      Normal volume headphones/clubbing with earplugs
      Sad to see research money wasted on these kinds of treatments.
       
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    4. Mentos

      Mentos Member Benefactor

      Location:
      Cracow, Poland
      Tinnitus Since:
      03/2015
      Cause of Tinnitus:
      Noise induced, loud rock concert
      What a crap.
       
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    5. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      E0BC2CF8-4E5E-43C4-AE75-C8426BE3316D.gif
       
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    6. Autumnly
      Wishful

      Autumnly Member Podcast Patron Benefactor Hall of Fame Advocate

      Location:
      Germany
      Tinnitus Since:
      July/August 2013
      Cause of Tinnitus:
      Noise induced
      So, it’s basically 50% TRT and 50% the opposite of TRT (no white noise but instead being in a quiet room to confront your tinnitus)?

      "This is finally an effective method," says Rilana Cima enthusiastically. She is a researcher at Maastricht University and a psychologist and coordinator of tinnitus expertise center Adelante. "By exposing patients to their ringing in the ears, they learn to become less sensitive to it."

      Wished she had stressed that while psychotherapy can help, it should be seen as a band-aid, we still very much need real treatments. People wouldn’t even need CBT for tinnitus if we could actually cure it.

      It’s also a bit distasteful to mention an article about Gaby Olthuis within this one, makes it seem like all she needed was some psychotherapy when she had actually tried TRT. At least mention how debilitating tinnitus can be.

      „[…] Tinnitus is more of a psychological problem and not audiological, which is why we have psychological treatment.“

      In Germany, this idea is already incredibly strong. There are people who are truly convinced that we don’t need any real treatments to reduce tinnitus because everyone can get used to it, it’s just a „matter of perception“, thus they believe psychological treatments will always be the best option.
       
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    7. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      This is the biggest problem the tinnitus community is facing IMO. How on Earth can we expect to get awareness and a real desire to develop a cure like cancer, diabetes, etc., when even some of our own researchers and community don't even want to bother for a treatment? I was having an argument with someone else here who said funding for CBT treatments is minimal, but this is the fourth one in a year. In comparison there have been 3 bimodal stimulation trials in that same time. This is much more than "minimal" funding and the hole needs to be plugged.
       
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    8. Drone Draper
      Jaded

      Drone Draper Member

      Location:
      U.K.
      Tinnitus Since:
      12/2018
      Cause of Tinnitus:
      NIHL, ETD and work stress
      My days, no more of this CBT research, please. CBT is coping. It's what a lot of people have to, because there's no effective treatment, but don't spend a penny more on researching this.

      Neuromod will probably be available privately in all the countries where we have universal health care, so time to start saving.
       
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    9. gadsie
      Angelic

      gadsie Member

      Tinnitus Since:
      2016
      Cause of Tinnitus:
      Normal volume headphones/clubbing with earplugs
      Since tinnitus is almost always a symptom of hearing loss, perhaps the focus should be on hearing loss research instead of tinnitus. I don’t see a lot CBT type stuff for hearing loss, meaning the money is probably better spent on hearing loss research.
       
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    10. Drone Draper
      Jaded

      Drone Draper Member

      Location:
      U.K.
      Tinnitus Since:
      12/2018
      Cause of Tinnitus:
      NIHL, ETD and work stress
      That would be the ultimate, I'm hoping one of the drug trials focused on the problem does ends up working.
       
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    11. Autumnly
      Wishful

      Autumnly Member Podcast Patron Benefactor Hall of Fame Advocate

      Location:
      Germany
      Tinnitus Since:
      July/August 2013
      Cause of Tinnitus:
      Noise induced
      Putting some comments I saw on Twitter under spoiler (blocked out their names), other people don't seem too pleased with it either.
      rsz_13.png rsz_12.png rsz_1.png
       
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    12. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
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    13. Drone Draper
      Jaded

      Drone Draper Member

      Location:
      U.K.
      Tinnitus Since:
      12/2018
      Cause of Tinnitus:
      NIHL, ETD and work stress
      Let's hope so. I left so many Facebook tinnitus groups because everyone is bluepilled and bitter.

       
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    14. Helheim
      Stressed

      Helheim Member Podcast Patron

      Tinnitus Since:
      01/2017
      Cause of Tinnitus:
      Infection
      Ah yes, the good old "get used to it" method.
       
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    15. Jazzer

      Jazzer Member Benefactor Hall of Fame

      Location:
      UK
      Tinnitus Since:
      1/1995
      Cause of Tinnitus:
      Noise
      When my tinnitus ramped up very considerably - courtesy of an arse’ole who changed the course of my life for ever - my doctor sent me to Guildford General Hospital to be assessed for a possible course of CBT.
      I filled in the usual lengthy questionnaire and was interviewed by a charming young lady for about an hour.
      She said that my knowledge of the whole Tinnitus scenario was pretty accurate,
      that I appeared to be psychologically of sound mind (pulled the wool over her eyes right enough)
      - and that she had nothing to offer me.
      (NOTHING - shame - as I said, she was quite charming.)
      Having read up a bit on CBT I knew that already.

      However (always be wary of howevers by the way)
      it does occur to me that my meditational practice bears some resemblance to CBT.
      (Oh - for chris’sake! what’s the old fool coming out with now ??)

      Offer me a smidgin of indulgence here please.

      When I lay in my nice comfortable warm bath, hear my tinnitus (obviously) assume my natural breathing rhythm and drift off into a meditative state, I feel fine.
      I do not feel harassed, hateful, angry, etc....
      I just feel fine - I feel okay.

      Obviously not a cure - but a calming strategy, involving willing familiarisation.

      But I can not avoid one particular proviso.
      My sounds are loud - no question about that.
      But they are essentially in the ‘hiss’ bracket.
      (Pressure cooker release valve.)
      Could my meditation method work if I had a shriek?
      I simply can not say of course?

      PS - please don’t let @threefirefour beat me up for being a bloody snowflake normie.
      I’m an old man don’t forget.
       
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    16. ajc

      ajc Member

      Tinnitus Since:
      11/2002; spike 2009; worse 2017-18
      Cause of Tinnitus:
      Loud music - noise damage
      Did anyone see the second article from RTL Nieuws - addressing the same therapy? Kevin still does not like his tinnitus sound but now he feels it is more manageable. Isn't that what happens after a while for so many people without any attempt at treatment?

      https://translate.google.com/transl...n-veranderd-door-nieuwe-behandeling-oorsuizen

      "New therapy helped Kevin with tinnitus: 'Tears jumped in my eyes'"

      Instead of addressing the problem auditory, he received behavioral therapy. The tinnitus was no longer masked, but rather looked up. The situations were simulated in which Kevin is most affected by his tinnitus.

      So he had to spend time in a quiet room. "That was very intense, the first time the tears jumped in my eyes", says Kevin. "Normally I always made sure that I had music, but now it suddenly stopped working and that made it worse at the beginning."

      After four treatments Kevin is not suddenly 'miraculously' healed. Yet the therapy has made a lot of difference for him. "I do not like it, the beep is still there, but it has become a lot less," he says. "At the beginning, I wanted to stop the sessions, it just seemed to get worse, but now it just feels less."

      In stressful situations Kevin notices that he will get more problems again. "But then I use the tools to make it less so again, I know now: it is still present, but manageable."

      Treatment is catching on

      The treatment that Maastricht University has now developed with a team of audiologists and psychologists is effective. No less than 85 to 90 percent of the research group experience an improvement.

      Maastricht University and care group Adelante are the first organizations worldwide with this treatment. Treatment will also be needed soon in Brabant, Utrecht and Noord-Holland. Even better news: the method will also be reimbursed starting this year.
       
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    17. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      Doctor: “Good news! The cancer has spread and is spreading rapidly!”
       
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    18. DaveFromChicago

      DaveFromChicago Member

      Tinnitus Since:
      01/2014
      Cause of Tinnitus:
      Headcold/Flu
      I find it incomprehensible that these specious rationalization approaches are still seriously offered. Can you imagine "just learn to process this" advice given to sufferers of migraines, arthritis, lower back pain, toothaches, joint sprains, intestinal flu, bronchitis, et.al.? Why are these groups so in denial that tinnitus is so akin to debilitating, chronic pain?

      These CBT advocates should listen to the 2012 YouTube "Tinnitus Nightmare" video wherein an older gentleman actually reproduces the loud, shockingly invasive noise he constantly hears. I defy anyone to not be undermined by such an extreme condition. I am suspicious that trivializing this condition with this CBT approach is just another means of receiving revenue since no truly effective drug and/or treatment is yet available.
       
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    19. Jazzer

      Jazzer Member Benefactor Hall of Fame

      Location:
      UK
      Tinnitus Since:
      1/1995
      Cause of Tinnitus:
      Noise
      In 200,000 years nobody has ever cured tinnitus.
      I sincerely hope that a cure comes, but we have no way of knowing that, do we.
      In the mean time we need to survive, and survival depends on our ability to cope.
      There can be no harm in experimenting with coping methods can there?
      They must not be touted as a cure - because a cure? they patently are not!
      But if these methods help - make life even a little bit more liveable, then where’s the harm?
      Guided meditation has been taught for years.

      However, pouring tons of money into CBT ‘research ?’ would be a scam.
      What there is to be known about CBT / meditation is already known.

      On a day when I meditate I am invariably okay.
      On the very occasional day when ‘life’ gets in the way, and there’s literally no time, then I may not be.

      Just a personal view folks.
      Dave x
       
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    20. Greg Sacramento

      Greg Sacramento Member Benefactor Hall of Fame

      Tinnitus Since:
      April 2011
      Cause of Tinnitus:
      syringing and now somatic T dental work
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    21. Jazzer

      Jazzer Member Benefactor Hall of Fame

      Location:
      UK
      Tinnitus Since:
      1/1995
      Cause of Tinnitus:
      Noise
      *** Both brilliant xx
      - and will be appearing on my Facebook page in a few minutes !

      See - sometimes you come up with the real goods Greg - now we just gotta work on the times inbetween...!! xx



      A52A293C-15CA-4875-9A3A-8DC851437606.jpeg
       
    22. Contrast

      Contrast Member Benefactor Hall of Fame

      Location:
      Retrovile
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      injury from noxious noise
      be7.jpg

      The University of Maastricht's treament in a nutshell. It's just awful.
       
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    23. Manny
      Dead

      Manny Member Benefactor Hall of Fame

      Location:
      United States
      Tinnitus Since:
      1/2018
      Cause of Tinnitus:
      central gain << NIHL
      (Translated text) "By exposing patients to the ringing in the ears, they learn to become less sensitive to it."

      Do I need "treatment" to attain that?? I am already 'exposed' to the ringing in my ears... because I have tinnitus!

      What am I missing here - what does this "treatment" consist of besides someone with bunch of letters after their name sitting and advising me to focus on my tinnitus??
       
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    24. Jazzer

      Jazzer Member Benefactor Hall of Fame

      Location:
      UK
      Tinnitus Since:
      1/1995
      Cause of Tinnitus:
      Noise
      Hi Manny
      - as you know, I hope, I am sceptical about every bloody thing:
      Father Christmas,
      God,
      the afterlife,
      the tooth fairy,
      etc....need I go on?

      Obviously meither I nor anyone else has found a treatment, much less a cure.
      I honestly wouldn’t recommend any course of action if I hadn’t tried it out and found it helpful.
      I personally would not pay for CBT believing that you can learn deep relaxation/meditation from a couple of sessions with a therapist, or in a class.

      For me the method is to:
      - lay down (in a warm bath is perfect),
      - don’t concentrate on your Tinnitus noise,
      (that is counter productive to me, painful and unnecessary),
      - just hear it,
      - ask your tummy to assume it’s natural breathing rhythm,
      - your tummy will take over your breathing for you,
      - think of nothing,
      - just achieve a body - mind - surrender,
      - be prepared to drift away in a nice peaceful slumber.
      Just stay with it for as long as it feels good.

      What you are doing is being prepared to hear your sounds, acclimatising yourself to them, without stress, anger, loathing, just acceptance.

      As you know, I’m not some airy-fairy dreamer.
      I have plenty of ‘T” in my head, but am coping reasonably well as we speak.

      Best wishes old sport,

      Dave x
      Jazzer
       
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    25. Jazzer

      Jazzer Member Benefactor Hall of Fame

      Location:
      UK
      Tinnitus Since:
      1/1995
      Cause of Tinnitus:
      Noise
      @Manny - never trust people with letters after their name.
      I knew a bloke once called

      Charlie Farnsbarns F.F.F.A.

      (He knew four fifths of fuck all !!)
       
    26. Bob den Hartog

      Bob den Hartog Member

      Tinnitus Since:
      11/2018
      Cause of Tinnitus:
      Noice induced
      Although I think this is pretty good advice for those with a pure tone, kind of to try to embrace the sound for the time being, for me this really works counterproductive. I have reactive / fluctuating tinnitus, and I noticed this morning that if I try to focus on other stuff, it remained a hiss. As soon as I really started to focus, it actually became more tones, and louder. As if I was telling my brain to make it worse. So, not doing that again :).
       
    27. Paulmanlike

      Paulmanlike Member Hall of Fame

      Tinnitus Since:
      2008
      Cause of Tinnitus:
      Noise
      Imagine being a vet serving your country and coming home with severe tinnitus for some clown to tell you to learn to live with it. I bet the politician who sends you to war wouldn’t be too happy with being told to learn to live with it.

      Absolute joke that it’s 2019 and the limited resources put into it.

      I remember reading something like over a billion is paid to vets for tinnitus and 1.1 million is given to research. I would hope that would be proper research, not some CBT shite.

      Saying that, tinnitus sufferers, at least a part of them, are their own worst enemy, there are millions of us worldwide and the ATA has only 20,000 paying members.

      The University of Maastricht can fuck right off! I’ll be leaning more on Neuromod.
       
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    28. Manny
      Dead

      Manny Member Benefactor Hall of Fame

      Location:
      United States
      Tinnitus Since:
      1/2018
      Cause of Tinnitus:
      central gain << NIHL
      Ay ay, I'm all for coping mechanisms for the people that they help - and I hope that they can help as many as possible.

      But for healthcare providers to portray coping methods as an awesome and great solution - and to wrap these relatively simple techniques in mumbo-jumbo and purvey them at an often-exorbitant cost - is to me a horrendous disservice to those who are not much helped by these methods and who are in dire need of a noise-reducing treatment.
      People, indeed such as myself.
      Best wishes to you as well friend.
       
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    29. Jazzer

      Jazzer Member Benefactor Hall of Fame

      Location:
      UK
      Tinnitus Since:
      1/1995
      Cause of Tinnitus:
      Noise
      I hope you know I’m on the same page as you Manny.
      I also need coping strategies to get me by.

      Dave x
       
    30. Pero1234

      Pero1234 Member

      Tinnitus Since:
      02/2018
      Cause of Tinnitus:
      home theatre system + high pressure washer
      I just read the news on a Belgian news website...

      The headline(s) took me by surprise:

      Good news for tinnitus patients, new treatment brings hope!

      What?

      I thought: finally some breakthrough news on Susan Shore’s device! Or Audion / Frequency Therapeutics!

      No... apparently they just now figured out CBT.

      Everyone already knows that sitting in silence and “accepting” your sound while breathing is the only way to stay sane with this thing in your head.

      The only thing is that the “treatment” is now fully covered by basic health care in the Netherlands... and maybe Belgium in a few years.

      That’s not hope... that’s not even good news. That’s just coping.

      I already learned about this coping mechanism in the book “Tinnitus: how to stop the ringing in your ears”.
       
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