Perspectives on Cognitive Behavioral Therapy for Tinnitus Management: Insights from an Online Forum

Introduction: Tinnitus treatment guidelines emphasize cognitive behavioral therapy (CBT) as the only recommendation for managing persistent tinnitus in the absence of hearing loss. This study aims to explore trends in discussions about CBT on the Tinnitus Talk online forum.

Methods: Tinnitus Talk is an online forum where users can discuss their experiences with tinnitus. Python was used to scrape any user-submitted posts mentioning CBT in the “Treatments” and “Alternative treatments” pages of the forum. These posts were analyzed for successful/unsuccessful usage of CBT, favorable/unfavorable opinions about CBT, and mentions of associated comorbidities. Sentiment analysis (RoBERTa Natural Language Processing) was utilized for positive, negative, and neutral connotations.

Results: A total of 580 posts mentioning CBT from 2012-2025 were analyzed, of which 64 (11.03%) posts reported CBT usage. Of these posts, 33 (51.57%) reported successful reduction in tinnitus following CBT, and 31 (48.43%) reported unsuccessful CBT. Alternatively, 200 (34.48%) posts did not mention CBT usage, but expressed strong opinions on its efficacy, nonetheless. Of these posts, 107 (53.50%) were optimistic about CBT as an effective treatment, while 93 (46.50%) expressed doubts about its efficacy. Sentiment analysis showed that most posts did not express positive sentiments (52.16% Neutral, 29.36% Negative, 18.48% Positive). Comorbidities commonly associated with tinnitus, such as anxiety (9.10%), depression (5.57%), sleep disturbances (7.07%), and migraines/headaches (1.09% of posts) were also discussed alongside CBT in these posts.

Conclusions: CBT is a divisive topic on Tinnitus Talk, with slightly more users reporting successful outcomes or expressing optimism about its efficacy. However, sentiment analysis showed that most discussions were neutral or negative, suggesting persistent skepticism or uncertainty among forum users. Clinicians should address patient concerns comprehensively during counseling, emphasizing the potential benefits of CBT and tailoring treatment approaches to account for comorbidities.