# Integrating the Sensation–Emotion–Cognition (SEC) Model into Tinnitus Care: A Preliminary Exploratory Study of a Comprehensive Tinnitus Management Protocol

## TL;DR

This study explores a new model for managing tinnitus by combining sound therapy, counseling, and cognitive behavioral therapy, showing promising results in reducing tinnitus-related distress.

## Contribution

The study introduces the SEC model as a novel multidimensional framework for tinnitus management and provides preliminary evidence of its effectiveness.

## Key findings

- Participants showed significant improvement in tinnitus management confidence after the intervention.
- Emotional distress related to tinnitus was significantly reduced following the SEC protocol.

## Abstract

Background: Tinnitus, the perception of sound in the absence of an external source, is a prevalent condition that can substantially affect physical and mental health. Although tinnitus is not typically curable, it is often manageable with structured, multidisciplinary care. This pilot research describes the Sensation–Emotion–Cognition (SEC) model, a practical audiological framework developed by Danesh et al. that targets three core dimensions of the tinnitus experience. Methods: We integrate findings from an exploratory retrospective cohort and a prospective expansion study. The SEC protocol included sound therapy, counseling and relaxation training, and cognitive behavioral therapy (CBT) delivered through either unguided, module-based internet CBT, clinician-guided module-based internet CBT, or six therapist-led CBT sessions. The objective was to evaluate whether this multifactorial approach is associated with reductions in tinnitus-related distress. Results: In this prospective study, preliminary results from 16 participants who completed the study were associated with significant pre–post changes in tinnitus-related outcomes: 4C management confidence increased from M = 30.38 to 60.19 (p < 0.001; Cohen’s dz = 1.04), and SAD-T emotional distress decreased from M = 4.75 to 2.38 (p = 0.001; Cohen’s dz = 0.99). Conclusions: These findings suggest the potential value of an integrated management strategy; however, given the single-group pre–post design and attrition, the results should be interpreted as exploratory and warrant confirmation in larger controlled trials.