A Comparison of Three Psychoeducational Group Interventions for Veterans With Tinnitus

NCT ID: NCT02293512

Last Updated: 2018-12-24

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-01

Study Completion Date

2016-11-30

Brief Summary

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Tinnitus (i.e., ringing in the ears) is currently the most prevalent disability among Veterans. A range of clinical interventions has been created to systematically address the range of issues caused by tinnitus. While numerous interventions purport to promote coping strategies for tinnitus-related problems, few studies directly target and measure coping outcomes. The present pilot study proposes a comparison of coping outcomes after 3 psycho-educational groups: a cognitive-behavioral therapy (CBT) intervention, a Coping Effectiveness Training (CET) intervention, or an Acceptance and Commitment Therapy intervention among Veterans with tinnitus. These groups will be compared to a usual care group among Veterans and civilians with tinnitus. The proposed study will be the first application of CET to tinnitus. The primary goals of this study are to develop a CET protocol for tinnitus and to evaluate the effectiveness of CBT, CET, and ACT interventions to a usual care group. The long-term goal of this study is to improve the quality of life among individuals with tinnitus.

Detailed Description

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Tinnitus (i.e., ringing in the ears) is currently the most prevalent disability in the VA system. Numerous clinical interventions have been created to systematically address the range of issues caused by tinnitus. Only a few tinnitus interventions have focused on coping strategies. Coping strategies are cognitive, affective, and behavioral attempts to master new events, such as the onset of a disability or an impairment like tinnitus, that are overwhelming to an individual, and that because of their newness, an individual does not necessarily have automatic, adaptive responses. Evidence suggests that CET is effective in facilitating adaptive coping strategies among individuals with several types of impairments or disabilities. The proposed study will be the first application of CET to a tinnitus population.

The present study proposes a development of a CET protocol for tinnitus and a pilot study that assesses the effectiveness of the CET and ACT interventions compared to the current clinical practice of using a CBT intervention. All 3 psycho-educational interventions will be compared to a usual care group. The overarching goal of the proposed pilot study is to gain information that can be used to provide individuals with tinnitus with the best care for helping them to more successfully cope with tinnitus.

The aims of this research are to: 1) develop a CET protocol for tinnitus by means of information gathered from two focus groups and from CET consultants; 2) to examine whether a 3-session CET psycho-educational intervention is more effective than a 3-session CBT psycho-educational intervention or a 3-session ACT psycho-educational intervention, as compared to a usual care, in increasing coping strategies among individuals with tinnitus.

Conditions

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Tinnitus

Keywords

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Tinnitus Coping Psychoeducational intervention

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Coping Effectiveness Training

Coping Effectiveness Training (CET) is provided in a 3-session intervention to facilitate coping strategies among individuals with tinnitus. The CET psychoeducational intervention teaches coping skills to increase understanding of stress and coping with tinnitus, and to help individuals better know how to match appropriate coping strategies, based on whether the stressful situation is changeable or not.

Group Type EXPERIMENTAL

Coping Effectiveness Training

Intervention Type BEHAVIORAL

A CET psychoeducational intervention is provided to increase understanding of stress and coping with tinnitus, and to better learn how to match appropriate coping strategies, based on whether the stressful situation is changeable or not.

Cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) is provided in a 3-session psychoeducational intervention to reduce negative affectivity triggered by tinnitus. CBT treatments for tinnitus target the reduction of psychopathology by altering cognitive distortions, automatic thoughts, and core beliefs, as well as behavioral techniques to reduce physiological arousal.

Group Type ACTIVE_COMPARATOR

Cognitive-behavioral therapy

Intervention Type BEHAVIORAL

CBT treatments for tinnitus target the reduction of psychopathology by altering cognitive distortions, automatic thoughts, and core beliefs, as well as behavioral techniques to reduce physiological arousal.

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is provided in a 3-session psychoeducational intervention to decrease resistance to tinnitus and increase committed action based on values, despite having tinnitus.

Group Type ACTIVE_COMPARATOR

Acceptance and Commitment Therapy

Intervention Type BEHAVIORAL

An ACT psycho-educational intervention to reduce distress and resistance about having tinnitus and to increase committed actions based on one's values.

Wait-list control group

Wait-list control group involves no intervention. This is a 'usual care' group.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Coping Effectiveness Training

A CET psychoeducational intervention is provided to increase understanding of stress and coping with tinnitus, and to better learn how to match appropriate coping strategies, based on whether the stressful situation is changeable or not.

Intervention Type BEHAVIORAL

Cognitive-behavioral therapy

CBT treatments for tinnitus target the reduction of psychopathology by altering cognitive distortions, automatic thoughts, and core beliefs, as well as behavioral techniques to reduce physiological arousal.

Intervention Type BEHAVIORAL

Acceptance and Commitment Therapy

An ACT psycho-educational intervention to reduce distress and resistance about having tinnitus and to increase committed actions based on one's values.

Intervention Type BEHAVIORAL

Other Intervention Names

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CET CBT ACT

Eligibility Criteria

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Inclusion Criteria

Development Phase (Phase 1)-focus groups:


* 1\) Veterans;
* 2\) have chronic tinnitus that is sufficiently bothersome to warrant intervention-see below for explanation;
* 3\) able to communicate in English;
* 4\) willing and able to give written informed consent;
* 5\) use hearing aids if needed; and
* 6\) have participated in the PTM program at the VA Portland Healthcare System.

Testing Phase (Phase 2)-interventions:


* 1\) Veterans and civilians;
* 2\) have a score of at least 25 on the Tinnitus Functional Index (\[TFI\]; Meikle, J.A. Henry, et al., 2012);
* 3\) have two errors or less on a six-item cognitive screening instrument (Callahan, Unverzagt, Hui, Perkins, \& Hendrie, 2002);
* 4\) able to communicate in English;
* 5\) willing and able to give written informed consent; and
* 6\) use hearing aids if needed.

* nor have any other factor that would preclude full participation in the study.

Testing Phase (Phase 2)-interventions:

* having participated in the PTM program or Phase 1 of this study,
* or having any other factor that would preclude full participation in the study. Recruitment for Phase 2 will begin in year 1 once the CET protocol is finalized.

Exclusion Criteria

Development Phase (Phase 1)-focus groups:
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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VA Office of Research and Development

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Erin C Martz, PhD

Role: PRINCIPAL_INVESTIGATOR

VA Portland Health Care System, Portland, OR

Locations

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VA Portland Health Care System, Portland, OR

Portland, Oregon, United States

Site Status

Countries

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United States

Related Links

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http://www.ncrar.research.va.gov/

VAPORHCS National Center for Rehabilitative Auditory Research (NCRAR)

Other Identifiers

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RX001578

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

C1578-P

Identifier Type: -

Identifier Source: org_study_id