Our Approach to Tinnitus Care

Before Your Tinnitus Appointment

What to expect from tinnitus assessment and treatment at Adelaide Tinnitus and Hearing Care — and what we ask from you as part of the process.

Before we begin

If you are considering tinnitus treatment with our clinic, we ask that you read this information before attending your first appointment.

Tinnitus can be frightening, exhausting and, for some people, completely overwhelming. You may already have spent considerable time searching for answers, trying different treatments, or being told that you simply need to “live with it”.

We do not believe that “just live with it” is an adequate tinnitus management plan.

There are evidence-based ways of reducing the impact tinnitus has on your life. However, tinnitus rehabilitation is rarely a quick or passive process, and there is currently no treatment that can guarantee that tinnitus will simply be switched off.

Understanding this from the beginning is an important part of successful tinnitus treatment.

The goal is not necessarily to eliminate the tinnitus sound

People understandably come to a tinnitus clinic wanting one thing: for the tinnitus to stop.

Some people do experience a reduction in the perceived loudness, awareness or prominence of their tinnitus during treatment. However, this cannot be guaranteed, and treatment should not be judged solely by whether the sound completely disappears.

Our goal is to reduce how intrusive, threatening or disruptive tinnitus feels so that it occupies less attention and has less impact on sleep, concentration, emotional wellbeing and everyday life.

For many people, successful tinnitus management eventually means reaching a point where tinnitus may still occasionally be audible, but it no longer automatically captures attention or produces the same emotional or physical reaction.

You may notice it — and then simply move on.

This process is often referred to as habituation.

Habituation does not mean learning to tolerate something terrible. It means the brain gradually changing the importance it assigns to the tinnitus signal. As tinnitus becomes less important to the brain, it can increasingly fade into the background of everyday life.

Tinnitus treatment is an active process

One of the most important things to understand before beginning tinnitus management is that treatment is collaborative.

Our role is not to “cure” tinnitus for you. Our role is to give you the knowledge, tools, strategies and appropriate treatment that help your brain and nervous system change the way they respond to tinnitus — and to guide you through that process.

Your audiologist provides assessment, education, treatment recommendations, support and guidance.

However, meaningful improvement usually depends on what happens between appointments.

Developing new responses to tinnitus, changing unhelpful listening or avoidance behaviours, using sound appropriately and practising recommended strategies all require active participation.

Think rehabilitation, rather than a procedure

There may be technology involved. There may be sound therapy. There may be hearing devices or other tinnitus treatments.

But there is rarely a device that we can simply fit, switch on and expect to do all the work for you.

The most successful outcomes tend to occur when the clinician and patient work together.

Why your first appointment is so comprehensive

There is no single tinnitus treatment that is appropriate for everyone.

Tinnitus is a symptom rather than one single condition, and two people who describe a similar sound may require very different management.

For this reason, we do not recommend a treatment or device simply because someone has tinnitus.

We want to understand not only what you hear, but what may be contributing to the tinnitus and, importantly, why it is affecting you in the way that it is.

Your assessment may explore:

• Your tinnitus characteristics and history
• Your hearing, including areas a conventional hearing test may not identify
• Cochlear and auditory function where appropriate
• Your ability to understand speech, particularly in background noise
• Sound tolerance and sound sensitivity
• Sleep
• Tinnitus distress and its impact on everyday life
• Attention, monitoring and behaviours surrounding tinnitus
• Your response to different sounds
• Possible jaw, neck or other somatic influences
• Relevant medical history and potential red flags requiring investigation

The purpose is not to perform tests simply for the sake of testing. The assessment gives us the information needed to develop an individual management plan.

Your treatment plan will be individual to you

No two tinnitus treatment plans are exactly the same.

Depending on your assessment findings, treatment may include a combination of:

Understanding tinnitus

Education, counselling and strategies that reduce the threat and importance attached to tinnitus.

Sound-based management

Therapeutic sound enrichment, TRT principles, hearing devices or tinnitus sound therapy where appropriate.

Behaviour and attention

CBT- and ACT-informed approaches, attention strategies and changes to behaviours that may be maintaining tinnitus distress.

Sleep and sound sensitivity

Sleep strategies and specific management for hyperacusis or other forms of sound sensitivity where these are contributing.

Specialist tinnitus treatments

Lenire, Neuromonics or Oritone Tinnitus Therapy may form part of treatment when clinically appropriate.

Other health professionals

Liaison or referral to your GP, ENT, psychologist, physiotherapist or another clinician where appropriate.

More treatment is not necessarily better treatment

Our aim is to identify the factors that appear to be maintaining the tinnitus response for you and target those factors appropriately.

Technology can help — but it is not the whole treatment

Some people come to our clinic specifically seeking hearing devices, Lenire, Neuromonics, Oritone or another tinnitus treatment they have read about.

These treatments can be valuable when they are appropriately selected.

We do not begin with a product and then try to fit the patient to it.

We begin with you.

Technology may form part of your management plan, but a device does not replace understanding your tinnitus, addressing factors that maintain the tinnitus response, or developing effective self-management strategies.

Not every person with tinnitus requires a device, and not every person is suitable for every tinnitus treatment.

Where technology is recommended, we will explain why we believe it is appropriate, what we expect it to achieve, its limitations, and how it fits into your broader rehabilitation plan.

Be cautious about the tinnitus information you encounter

Many people arrive at their first appointment after spending hours, weeks or months searching for tinnitus information online.

Unfortunately, tinnitus information on the internet varies enormously in quality.

You may have encountered frightening explanations about permanent damage, warnings to avoid everyday sounds, lists of foods or activities you should never do again, supplements claiming to “cure” tinnitus, or stories suggesting that if one particular treatment did not work, nothing will.

More information does not always mean more reassurance

For someone whose brain is already monitoring tinnitus as a potential threat, continually searching for danger and reassurance can sometimes strengthen rather than reduce that response.

Part of good tinnitus management is helping you understand what information is relevant to your situation and separating evidence-based advice from misinformation, generalisations and marketing claims.

We want you to understand your tinnitus — not become frightened of it.

Medical investigation and tinnitus management are different things

Audiological tinnitus management does not replace appropriate medical investigation.

Certain tinnitus presentations warrant assessment by a GP, ENT specialist or another medical professional. If your history or assessment identifies something requiring further medical investigation, we will explain this and recommend the appropriate referral.

For many people, however, appropriate medical investigation is reassuring and does not identify a dangerous underlying condition.

There is an important difference between appropriate investigation and repeated reassurance-seeking.

Once appropriate investigation has occurred, repeatedly searching for another test or another explanation can sometimes keep tinnitus at the centre of attention.

Our clinic will recommend further investigation when it is clinically indicated. Once appropriate investigation has occurred, our focus shifts toward helping you move forward.

Improvement usually happens gradually

Tinnitus rehabilitation is not usually an overnight change.

Some people notice meaningful improvements relatively quickly. For others, changes occur gradually over several months.

Progress does not always begin with tinnitus becoming quieter.

Thinking about tinnitus less often.

Realising that you had forgotten about it for a period of time.

Sleeping better.

Feeling less frightened when you notice tinnitus.

Checking or monitoring it less frequently.

Returning to places or activities you had begun avoiding.

Finding that a temporary change in tinnitus no longer ruins your day.

These changes matter. Over time, they can represent a significant change in the brain's relationship with tinnitus.

Some people also experience reductions in tinnitus loudness or awareness. This can occur, but it cannot be promised.

What we ask from you

We do not expect you to arrive knowing how to manage tinnitus. Teaching you that is part of our role.

We also do not expect you to “just ignore it”, think positively, or somehow force yourself not to hear it.

What we do ask is that you are willing to participate in the process.

This may mean:

• Trying recommended strategies between appointments
• Changing behaviours that may have developed around tinnitus
• Using therapeutic sound as recommended
• Reducing unnecessary sound avoidance where appropriate
• Working on sleep, stress or other contributing factors
• Practising different ways of responding when tinnitus captures your attention

Some strategies may initially feel unfamiliar. We will explain why they have been recommended and adapt them where necessary.

Tinnitus rehabilitation is something we work on with you, rather than something we simply do to you.

When our clinic may not be the right fit

We want patients to understand our approach before investing their time and money in treatment.

Our clinic is unlikely to be the right fit if you are looking for:

• A guaranteed cure for tinnitus
• Someone who can promise to switch the tinnitus off
• A device or treatment without first having an appropriate assessment
• Certainty that a particular advertised treatment will work before you have been assessed
• A treatment that requires no participation or changes from you
• One appointment that will permanently solve a complex tinnitus problem
• Repeated testing or reassurance when appropriate investigation has already been completed, rather than moving toward rehabilitation

This does not mean your tinnitus needs to be mild.

You do not need to arrive confident about treatment, feeling positive, or already knowing how you are going to manage it.

Many people come to us because tinnitus is significantly affecting their life and they genuinely do not know what to do next.

That is precisely when specialist guidance can be valuable.

What you can expect from us

To be heard

We will listen carefully to your experience and take the impact of your tinnitus seriously.

A thorough assessment

Treatment begins with understanding your individual presentation, rather than applying a one-size-fits-all approach.

Honest recommendations

We will explain why a treatment is recommended, what it may achieve and where its limitations lie.

Evidence-based care

Your management plan will be based on current tinnitus rehabilitation principles and your individual clinical findings.

Realistic expectations

We will not promise outcomes that tinnitus treatment cannot reliably guarantee.

Ongoing guidance

Where rehabilitation is appropriate, we will guide and support you as you develop the skills to manage tinnitus more effectively.

Before your appointment

If you have read this guide and our approach sounds right for you, you do not need to arrive already feeling hopeful or confident.

You simply need to be willing to explore a different way of understanding and responding to your tinnitus.

Our role is to provide the map, the tools and the guidance.
Your role is to use them.

And we will work through that process with you.

If you are looking for a thorough assessment, an individual explanation of what may be contributing to your tinnitus, evidence-based treatment options and specialist guidance to help tinnitus become less dominant in your life, we look forward to working with you.

Adelaide Tinnitus and Hearing Care
Specialist tinnitus, sound sensitivity and hearing care