The original TEP has 6 modules, each module to be undertaken weekly and Outcomes measured in Week 10. It includes materials taking registrants up to the beginning of using CBT. This course is great for anyone with a THI (Tinnitus Handicap Inventory) score between 18 - 36 (Mild tinnitus distress - THI category 2) as well as many with a score between 38 - 56 (Moderate tinnitus distress - THI category 3).

The problem has been that more than 50% of people registering to use the Tinnitus E-Programme have THI scores in excess of 58% (Severe tinnitus distress - THI categories 4 and 5). With tinnitus distress as high, the 6 module course is insufficient to reduce tinnitus distress levels to a THI score of 0 - 16 (no tinnitus distress - THI category 1) or even to 18 - 36 (mild tinnitus distress - THI category 2)

This was the reason for changing the Tinnitus E-Programme from being self-directed to being therapist led in 2018; but it still isn't enough to have the necessary impact for people scoring in the THI categories 4 and 5. Indeed, many with moderate THI scores haven't managed to reduce their tinnitus distress to between 0 - 16 (no tinnitus distress) which of course is the objective!

So I have spent the past few months working on expanding the Tinnitus E-Programme. There are now 3 courses!

First, the Tinnitus E-Programme itself of course. But for those people who find there are still improvements to be made i.e. their THI category is still too high - meaning their tinnitus distress is too high - there is a new add-on iCBT for Tinnitus Course available. Many initially scoring in the THI moderate category (38-56) benefit from working through a course of CBT. Because the CBT is internet based it is known as iCBT.

You may well be interested to know that recent research has been able to demonstrate the same Outcomes whether CBT is delivered face to face or via the internet. I have been using iCBT for many years now, and my "internet" patients achieve just as good Outcomes as those I see in clinic face to face, so my findings are the same as evidenced in the research.

As a result, there is now an "add-on" iCBT course available for people after the Tinnitus E-Programme when they need it. It is most likely to be needed by those scoring 38-56 in their initial THI and the cost of the course includes 2 online appointments with me using Zoom, as well as full email support.

However, the biggest change I have made is to produce the Tinnitus E-Programme Plus+

I am really pleased with it and hope those that use it will be too! It merges together everything in the Tinnitus E-Programme and the iCBT for Tinnitus course, but the flow is a little different because naturally, you won't be finishing one course and starting another. It includes 3 online appointments with me using Zoom and email support throughout.

The Tinnitus E-Programme Plus+ course is suitable for people with an initial THI score of 58+ (THI categories 4 and 5) and the fee for the course can be paid in installments making is easier to pay for. It works out at two-thirds cheaper than all one to one face to face clinic appointments. And as we know already, the research bears out that Outcomes are comparable.

"Effectiveness of Guided Internet-Based Cognitive Behavioral Therapy vs Face-to-Face Clinical Care for Treatment of Tinnitus: A Randomized Clinical Trial" by Beukes et al, published 4 October 2018 can be viewed on the JAMA Otolaryngology - Head & Neck Surgery website CLICK HERE to go to the paper on their website.

Debbie Featherstone

Tinnitus E-Programme 2009-2018