Review written at Stage 6 (17 weeks after joining CBT4T)

Tinnitus Functional Index (TFI) 17 weeks post-enrolment: 82.4% very big problem category 5 (73-100%) > 28.4% small problem category 2 (18-31%)

Ian's full feedback at Stage 6:

Q: Would you recommend others with severe tinnitus distress to use the course, and if so, what would you say to them?

A: "I would certainly recommend this course. I started with anxiety and distress around my tinnitus and had tried another course prior to this one which was actually one-to-one but was not working for me. This course has covered many things that have been useful and have helped me make steps to regaining my life. Tinnitus has been one of the hardest things I've had to deal with, this course has certainly helped me to do so."

Q: What benefit have you experienced using the relaxation element of the course so far?

A: "I hadn't intentionally used relaxation techniques before. That said, I was aware that slow, relatively deep, controlled breathing felt good and had a calming effect. I used them, when I remembered to. It has been good to formalise this knowledge and build on it and I have continued to try and use it much more. I used it more at the beginning of the course, and a little less recently and I think this is evidence of my more relaxed, less anxious state. Life throws problems at us and I'm sure there will be an uptick in its use as the next problem arises."

Q: How has the neuroscience-based learning about the amygdala, autonomic ladder and brain plasticity helped you to relate to your experience of tinnitus, anxiety and stress?

A: "The neuroscience aspects have been very welcome. I think as we navigate life we come across things that cause us distress and, for me, learning about the things that are causing this distress help demystify them. I'm never going to become a neuroscientist but I don't need to be, I just need enough knowledge to help me comprehend and explain what is going on. Then, like a problem shared, the weight of the experience begins to lift. This helped turn down the associated anxiety and move into a mindset of getting past the problem."

Q: What have you learned from the costs & benefits transaction work (used from stage 3)? Estimate how much you have already adjusted from having a problem-oriented perspective towards a recovery-oriented perspective (e.g. 2/10 > 7/10 indicates an improvement of 5 so far)

A: "The costs-benefits work helped to set the scene for changing my mindset. I found this, in conjunction with the explanations of cognitive distortions and the meaning adjuster really useful. I think I've moved from 2/10 to 6/10. I'm still working on this, challenging my negative self-dialogue."

Q: You are likely to have had your first 1-1 by now. Did you benefit from your 1-1 and if so, how?

A: "I've had two 1:1s now. They have been very useful. I can understand why, for a 'typical' attendee you say to wait for the first meeting. I'm also glad, that with my perhaps more atypical presentation, tinnitus with a side helping of potential Meniere's/AIED/ETD, I was able to see you sooner."

Q: What is your own impression of your progress to date?

A: "Progress is not linear and that is fine. For me, most progress was made at the beginning of the course. This is perhaps to be expected."