A guest post by James to mark Tinnitus Week and Tinnitus UK’s Annual Report, aimed at those who suffer with their tinnitus and are wondering where to turn.
As we reach the end of Tinnitus Awareness Week 2025, it’s time to take stock. As a co-author of this year’s report from Tinnitus UK, it’s so pleasing to have seen our findings hoover up media attention and encourage meaningful engagement from those in the tinnitus field. I have been in the Mail on Sunday, Radio Leeds and on Look North, and colleagues have flown the flag and sat on TV sofas nationwide.
It you are interested in reading our report “Ringing the Alarm: The Tinnitus Care Crisis”, you can go to the Tinnitus UK website to download a free copy: Tinnitus Week report exposes the critical gaps in UK tinnitus care - Tinnitus UK
Ultimately, the report is exposing critical gaps in tinnitus care. Apart from excessive NHS waiting times measured in months and years, severely impacting mental health and quality of life, there’s a low priority for tinnitus care in the private sector. I think it’s fair to say that in some cases, profit is being put ahead of patients. The (tinnitus-specific) training of audiology graduates and other hearing healthcare professionals is also low and of variable quality, leading many in the industry being ill-equipped to address the needs of tinnitus patients.
Finally, the National Institute of Health Care and Excellence (NICE) brought out guidelines for the assessment and management of tinnitus in 2020. You can read these here, and I feel it is important that you do: Overview | Tinnitus: assessment and management | Guidance | NICE. This guidance should help with your expectations and lists the interventions with the best evidence-base and thus, the greatest chance of being beneficial.
Unfortunately, as our report states, many hearing healthcare professionals, for whatever reason, deviate from established standards, with some offering unaccredited Cognitive Behavioural Therapy (CBT) for tinnitus management. Although there are many pathways to accreditation as a CBT practitioner, these take many years, requiring training from even more experienced professionals. Accreditation lists should be checked: BABCP | British Association for Behavioural & Cognitive Psychotherapies > Accreditation > Post-Accreditation Guidance > How do I prove that I am Accredited?
In reality, the number of people who are: (i) very knowledgeable about tinnitus, and (ii) hold the sufficient accredited to properly dispense CBT is low. In the UK as a whole, I suspect this amounts to perhaps fifteen people. In total. So please be aware. Just because someone says they provide ‘CBT for tinnitus’, this does not make it true.
So what should hearing healthcare professionals be doing? For starters, statements like “There’s no cure for that, you’ll just have to live with it” should be avoided at all costs. It is actively cruel. It’s also surprisingly helpful if your audiologist has tinnitus and/or some hearing loss themselves. It helps with rapport, empathy and understanding.
If the audiologist is knowledgeable – and this is key – then they should not be working off a set script or protocol. That’s a red flag – a ‘one size fits all’ approach. My wife, Sally, is a good example of how things should be done. Every tinnitus consultation should be different, as every patient with tinnitus is different – different causes, different triggers, different environments, different levels of hearing loss. Indeed, 20% of people with tinnitus don’t have a hearing loss!
You should be looking for a detailed explanation of what tinnitus IS, how we hear and respond to it. The audiologist may have you complete some short tests (including one or two valid and meaningful questionnaires*), and they should be skilled in interpreting them. They should be conducting a proper, in-depth interview of you and your relationship with your tinnitus. Not all treatments work for everyone, after all. There’s no point reading from a set script and working down a list of options that will not/have not worked for you.
*Red Flag: Can your hearing healthcare professional explainwhy they are using particular questionnaires, and whether or not they are valid and meaningful?
Once all that context is in place, and your individual concerns have been answered, you should be moving on to an educational module, during which you can give feedback, reflect, and suggest your own tailored structure. It’s a two-way street.
Sally has more than a decade of clinical experience with tinnitus patients, and like me, she knows the different between having tinnitus, and being distressed by your tinnitus. A clear and structured pathway to the former is possible.
Dr James Jackson is a Reader in Psychology at Leeds Trinity University and an Associate Fellow of the British Psychological Society, as well as being a member of the Scientific Advisory Board for Tinnitus UK. He has published multiple academic papers on the subject of tinnitus. Here, all views are his own.
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