# Acceptance and commitment therapy for patients with chronic tinnitus resistant to tinnitus retraining therapy: A case series

## TL;DR

This study explores the effectiveness of Acceptance and Commitment Therapy (ACT) for patients with chronic tinnitus who did not benefit from traditional therapy.

## Contribution

The study introduces ACT as a novel therapeutic approach for tinnitus patients unresponsive to TRT.

## Key findings

- Three out of four patients showed a clinically meaningful reduction in tinnitus handicap after 6 months of ACT.
- Patients without hearing loss showed greater improvement in psychological measures like CFQ-7 and HADS.
- VQ scores showed minimal change across all patients.

## Abstract

Tinnitus retraining therapy (TRT) promotes habituation in chronic tinnitus but is less effective in patients under psychological distress. Acceptance and commitment therapy (ACT) offers an alternative by enhancing psychological flexibility rather than targeting symptom reduction.

Five patients with chronic tinnitus unresponsive to TRT completed the ACT program. Among them, four completed the 6‐month follow‐up and are presented in detail. While Case 1 was previously reported, this analysis includes all four to explore ACT's broader application. The intervention targeted ACT's six core processes. Outcomes were measured using the Tinnitus Handicap Inventory (THI), Cognitive Fusion Questionnaire‐7 (CFQ‐7), Valuing Questionnaire (VQ), and Hospital Anxiety and Depression Scale (HADS). After 6 months, three patients showed a clinically meaningful THI reduction. Those without hearing loss improved more in CFQ‐7 and HADS. VQ scores showed minimal change.

ACT may help patients with TRT‐resistant tinnitus, particularly those without hearing loss.