Tinnitus Retraining Therapy

Tinnitus Retraining Therapy (TRT) was developed by Pawel Jastreboff, Ph.D. and is based on his neuophysiological model of tinnitus. This method of treatment requires two components – directive counseling and sound therapy. Directive counseling focuses on education about tinnitus/hyperacusis and the interactions with other systems in the body. Sound therapy is used to help the brain get used to the sound of the tinnitus while decreasing the contrast between the tinnitus and a silent environment. This may include environmental sound enrichment, the use of ear level sound generators (SG), the use of hearing aids (HA), or the use of combination instruments (SG + HA in one unit). The exact treatment is based on the initial diagnostic evaluation, patient’s preference, and lifestyle demands.

The goal is to achieve habituation of the tinnitus. Habituation means the tinnitus is no longer perceivable unless the patient intentionally focuses on it. Even when it is perceivable it is no longer bothersome. Therapy addresses both the perception and reaction to the tinnitus. TRT typically requires a 9-18 month commitment.