Tinnitus therapy isn’t a one-size-fits-all approach. There are a wide range of options available, and often my clients tell me how overwhelming it can be to determine which method will offer the most relief. From sound therapy to Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness, there’s no shortage of approaches to explore. But what’s the right one for you?

One common misconception is that tinnitus therapy requires choosing one method and sticking with it. The truth is, it’s not about picking the right therapy from a list – it’s about transitioning through a combination of treatments. As your understanding and experience with tinnitus evolves, so should the therapies you use.

You may have been told that sound therapy is terrible, or the opposite – that it’s the only way forward. Or you may have been told that CBT is the only way to manage your tinnitus. Rather than rigidly committing to one therapy, I have found that a multi-faceted approach is often most beneficial.
The ultimate goal of therapy is learning how to live well with tinnitus, managing your reaction, and cultivating resilience over time. Let’s break down some of the common therapies used and how they might fit into your tinnitus journey.

Sound Therapy
When most people first experience tinnitus, it’s hard to ignore. The constant noise in your ears can feel all-encompassing. This is where sound therapy comes in. Sound therapy uses external sounds – like white noise, nature sounds, or music – to help distract you from the tinnitus and make it less noticeable. It’s a great starting point because it offers immediate relief by distracting the brain from focusing on the perceived noise in your ears.
While sound therapy can help alleviate the intensity of tinnitus in the short term, in my opinion, it’s not a permanent solution. It’s the first step in the transition toward a more holistic approach to managing tinnitus. Interestingly, I sometimes reintroduce it later in the journey to address tinnitus fluctuations – but only after someone has developed better control over their reactions.

Cognitive Behavioural Therapy (CBT): Gaining Control
Once the initial discomfort is alleviated through sound therapy, you can move toward Cognitive Behavioural Therapy (CBT). CBT is based on the idea that our thoughts influence our feelings and behaviours. In the context of tinnitus, CBT helps individuals reframe negative thoughts and emotions about their condition, which can, in turn, reduce distress.

Through CBT, you learn to challenge the unhelpful thoughts that might fuel your reaction to tinnitus, such as feelings of frustration, anxiety, or helplessness. CBT teaches you to recognise that while you cannot always control the tinnitus itself, you can control how you respond to it. This sense of empowerment is key to regaining control over your life.

Acceptance and Commitment Therapy (ACT) & Mindfulness
After you’ve gained some control through CBT, you may find that it’s time to deepen your approach. This is where Acceptance and Commitment Therapy (ACT), combined with mindfulness, comes in.

ACT focuses on accepting tinnitus rather than fighting against it. Acceptance does not mean “giving up” or “being happy that you have tinnitus”. This approach encourages you to make room for your tinnitus without allowing it to dictate how you feel or what you do. Mindfulness techniques, which are a core part of ACT, teach you to be present in the moment, without judgment. By practicing mindfulness, you learn not to react negatively to your tinnitus, reducing its emotional power.
In ACT, the focus is on psychological flexibility – being able to engage with your tinnitus in a way that allows you to continue living according to your values, even if the tinnitus is still present. It’s about accepting the discomfort and moving forward, rather than trying to eliminate the experience entirely.

So, what’s the right therapy for tinnitus? The answer is simple: it’s a combination of all these therapies – sound therapy, CBT, ACT, and mindfulness – that offers the most comprehensive and lasting relief. You might start with sound therapy to help you cope with the initial distress, then move to CBT to reframe negative thoughts, and eventually transition to ACT to build resilience and acceptance. These therapies aren’t exclusive; they work best when integrated together in a progressive, evolving treatment plan.

Tinnitus therapy is not about finding a single “right” solution – it’s about moving through different therapies at the right times in your journey. Sound therapy, CBT, ACT, and mindfulness all play important roles in managing tinnitus and improving your quality of life. Remember, tinnitus therapy is a transition. What works for you at one stage of your journey might evolve as you learn more about yourself and your condition. By incorporating all of these therapies over time, you can take control of your tinnitus and learn to live well with it – without allowing it to define you.