Talk:Tinnitus retraining therapy

unsupported claims removed, edited
In accordance with Wikipedia practice that "Encyclopedic content must be verifiable" removed "The notion that there is "no known cure" for tinnitus is a flawed concept within TRT. " until a citation can be provided for a scientific study concluding there is a cure for tinnitus. Changed "When a patient has successfully habituated using TRT, the perception of tinnitus frequently returns to the previous level of awareness before perception became problematic." to "If a patient has successfully habituated using TRT, the perception of tinnitus frequently returns to the previous level of awareness before perception became problematic." to reflect that successful habituation is not an absolute certainty.Tomandzeke (talk) 20:09, 21 April 2012 (UTC)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5562945/ Not sure if I should put this here ( new to Wikipedia ) but to hopefully shed light on the concept that Tinnitus doesn't need a " cure " is clear to anyone who has undergone TRT successfully as I have. Tinnitus is not a disease just the ability to hear the neuronal activity of the auditory cortex. The ability to habituate depends on the strength of the adverse reaction to this new and sometimes unwelcome ability. Theres a lot of confused opinions here that are very unhelpful for someone newly disturbed or worried about having tinnitus. — Preceding unsigned comment added by Tinman504 (talk • contribs) 13:41, 14 February 2019 (UTC)

Removed (ringing ears) from "Tinnitus retraining therapy (TRT) is a form of habituation therapy designed to help people who suffer from tinnitus (ringing ears)." to reflect that tinnitus can cause the perception of other sounds; see: Wikipedia entry for tinnitus which states "Tinnitus can be perceived in one or both ears or in the head. It is usually described as a ringing noise, but in some patients, it takes the form of a high-pitched whining, electric buzzing, hissing, humming, tinging or whistling sound, or as ticking, clicking, roaring, "crickets" or "tree frogs" or "locusts (cicadas)", tunes, songs, beeping, sizzling, sounds that slightly resemble human voices or even a pure steady tone like that heard during a hearing test.[3] It has also been described as a "whooshing" sound, as of wind or waves.[4]"Tomandzeke (talk) 20:09, 21 April 2012 (UTC)

possibly misleading sentence
One sentence looks as if it is improperly formed, leading to possible miscommunication: "... problems ... include annoyance, ..., sleep, and concentration disturbances." I suspect that it should read: "... problems ... include annoyance, ..., and disturbances in sleep and concentration." RichMorin (talk) 22:58, 15 December 2013 (UTC)

Single source and problemmatic article
The whole concept of tinnitus retraining is a kind of pseudoscience, whose results are almost wholly subjective. I find it deeply disturbing that almost the entire article, its refs, and external links are about one person and his model: the Jastreboff model. Yet this article is presented as scholarship. It needs to be redrafted to eliminate most references to the man and the model. Not that his model is invalid, but simply that if there's anything to this topic, it should have independent sources. What text there is woefully inadequate to help anyone understand what TRT is. What's 'directive therapy'? What do tinnitus maskers do? What's sound (music) therapy? I listen to music all day, is that therapy?? The whole article needs redrafted, and concepts explained.Sbalfour (talk) 03:01, 30 November 2015 (UTC)

Neutrality (POV)
My initial reading of this article (before I cleaned it up some, though it needs way more) gave me the impression (and false hope) that TRT is a recently developed possibly miraculous medical treatment for tinnitus; the title is somewhat reminiscent of 'physical retraining therapy' for injured or crippled limbs that IS medical treatment. Specifically, the article fails to mention:


 * TRT doesn't reduce or eliminate tinnitus (at least no good evidence for this)
 * TRT doesn't help everyone; in fact a few sufferers are worse off after TRT than before, though this may be a natural progression of the disorder rather than an effect of TRT
 * some sufferers are not good candidates for TRT; however, because TRT providers are a for-profit cottage industry that in essence preys on the desperate, the unknowledgeable and the gullible, screening is non-existent, weak or inappropriate
 * TRT is not a medical treatment for tinnitus - the science supporting TRT is nascent, and wholly in the research stage - clinical practice cannot really be supported
 * nor is TRT an accepted facet of clinical psychology; the music therapy part of TRT in particular is pseudoscience, not part of either clinical medicine or psychology
 * tinnitus tends to diminish of its own accord in a large proportion of sufferers, though the time period is often long, possibly years, so TRT may be no better than no treatment
 * Even if it's better than no treatment, TRT may amount to a kind of placebo effect. Since tinnitus and TRT are wholly subjective phenomena, until the objective science advances, it's difficult or impossible to separate the effect of TRT from self-fulfilling prophecy.
 * tinnitus interventions including TRT often have only a temporary effect, and tinnitus reverts to its previous level

It's unlikely that many medical providers - medical doctors, ENT's, audiologists - will refer patients to TRT practitioners for treatment, for similar reasons that doctors are unlikely to refer patients with back or neck pain to an osteopath or chiropractor. TRT therefore at present falls squarely into the alternative medicine category.

Sbalfour (talk) 20:16, 30 November 2015 (UTC)

What's this article about?
A not-too-knowledgeable person (like me) who initially comes upon this article by trying to match symptoms I'm having with diagnosis, treatment, and general info about my condition, would have some obvious questions: I can't reasonably answer any of these questions from the existing text in the article. Indeed, I would say that any portion of the article not part of answering these questions is irrelevant and could be scrapped. I previously removed a 'rewrite' maintenance tag from the article, but I might have been hasty. We're not all sycophants for Jastreboff; much useful and objective information is obviously missing.Sbalfour (talk) 15:02, 1 December 2015 (UTC)
 * Do I have tinnitus (and do I have it severe enough, and the right 'kind' that tinnitus retraining therapy could be a treatment for me)?
 * how long will therapy take (weeks, months, possibly years)?
 * how often will I have to see the doctor or other provider (every few days, weekly, bimonthly, etc)
 * does it work (and if it works at all, how effective is it)?
 * how much does it cost?
 * are there any side-effects or adverse effects I would want to take into consideration?

Copyright problem removed
Prior content in this duplicated one or more previously published sources. The material was copied from: https://www.ohiohealth.com/anatomicalstructure/bodyobject/tinnitus/. Copied or closely paraphrased material has been rewritten or removed and must not be restored, unless it is duly released under a compatible license. (For more information, please see "using copyrighted works from others" if you are not the copyright holder of this material, or "donating copyrighted materials" if you are.)

For legal reasons, we cannot accept copyrighted text or images borrowed from other web sites or published material; such additions will be deleted. Contributors may use copyrighted publications as a source of information, and, if allowed under fair use, may copy sentences and phrases, provided they are included in quotation marks and referenced properly. The material may also be rewritten, providing it does not infringe on the copyright of the original or plagiarize from that source. Therefore, such paraphrased portions must provide their source. Please see our guideline on non-free text for how to properly implement limited quotations of copyrighted text. Wikipedia takes copyright violations very seriously, and persistent violators will be blocked from editing. While we appreciate contributions, we must require all contributors to understand and comply with these policies. Thank you. Lucas559 (talk) 18:20, 1 December 2015 (UTC)
 * I was the errant editor. And I didn't copy the text from the source you cited (by the way, that site doesn't own the copyright to that text).  I subsequently did a search for the supposed copyrighted text, and found it on 17,200 websites.  With slightly different spacing, linebreaks, and punctuation, I can find that text on many tens of thousands of websites.  Inquiries as to copyright, I get that either they don't know, don't own the copyright, or got the text from an affiliated website, or etc.  With text that generic and prevalent, it is unlikely that we shall never find who if anyone actually owns the copyright.  It's effectively in the public domain.  None-the-less, out of an abundance of caution, I've condensed and substantially restated the text and added the restatement to the article.Sbalfour (talk) 20:47, 1 December 2015 (UTC)

lead paragraph obscure
I'm not sure I know what either of the two key phrases (facets) of tinnitus retraining therapy means: "reclassification of tinnitus to a category of neutral signals", and "weakening tinnitus related neuronal activity". These phrases were copied more or less verbatim from a seminal research paper. Not exactly copyvio, because the precise technical wording is rather vital. However, to the non-medical layman, they don't tell me what therapy is about.

I propose replacing all or most (except the description of tinnitus itself) of the opening paragraph with:

Tinnitus Retraining Therapy (TRT) is a form of habituation therapy which is a combination of two unrelated modalities: a form of Cognitive Behavioral Therapy (CBT) that may help sufferers understand and cope with the debilitating effects of tinnitus, and a limited or threshold form of sound therapy to partially mask the tinnitus. These two modalities were combined into TRT by an early tinnitus researcher in 1990. The underlying theory is that tinnitus is caused by sporadic activity of the autonomic nervous system (things that happen outside our conscious awareness or direction) related to auditory processing, and that that activity may be modulated by psychological and/or acoustic means.

Sbalfour (talk) 19:41, 4 December 2015 (UTC)

External links propriety?
I can find no information on the American Tinnitus Association, British Tinnitus Association or German Tinnitus Foundation websites that the associations sanction TRT, or that members of the associations include TRT practitioners or businesses. The inclusion of these links gives an improper implication that TRT is a scientific or medical procedure, which it is not. What would be supportable, is to rename and direct links to pages on those websites that have specific information on TRT. I can find none. The links ought to be removed, as they don't point to additional information not included in the article. Sbalfour (talk) 21:59, 24 February 2022 (UTC)

Categories
TRT is in categories Audiology as well as Alternative medicine. Audiology is a scientific discipline and a medical subspecialty. TRT is neither. I think these categories are contradictory. Also, including it in category Ear procedures is quixotic: Ear procedures category page includes physical or medical procedures on ears, like ear cleaning, ear piercing, stapedectomy, etc. TRT is mostly jawboning and wearing a tinnitus masker (though they don't call it that). Wearing a hearing aid, ear plugs, headphones or ear muffs are not considered "ear procedures", nor should using or wearing a tinnitus masker. The category is just inappropriate. Including TRT in category Music therapy is also specious, as those pages are devoted to psychosocial and personality aspects of music therapy. TRT does not use music in its sound therapy. It just seems like overreaching. Mind-body interventions is also an awkward category to include - that page indexes articles that are New Age-y wellness procedures like aromatherapy, and none of them are specifically therapeutic, whereas TRT is a very specific therapeutic procedure for tinnitus with almost no application to any other condition or in any other context. It just seems like someone is expansively giving this article undue exposure. It's a very narrow focus article, and the number of categories that can subsume it is very, very few. There's some subtle marketing going on here and it needs to be trimmed back. Sbalfour (talk) 22:23, 24 February 2022 (UTC)

Commercial connections
This methodology which is still very much in the research stage, has been commercialized since about 1992 by the developer(s) and their and associates for private profit, first as a series of private clinics in Canada and later elsewhere. The practitioners are all trained by the same small group of people. Even the studies are often conducted mostly by associates and proteges of the practitioners, and that's not at all apparent to the clients who enroll at their clinics. It's a troublesome connection, one that you have to dig to discover. TRT doesn't attract enough attention that I can find an expose of it in something like the NY Times. It's almost a counter-culture thing. The medical and psychology establishments shine it on, because it's not a medical or psychological procedure. The practitioners are laymen, not medical doctors or licensed psychologists or audiologists. We should have something about the commercial implications in the article, if I can find documentary support. Sbalfour (talk) 19:41, 27 February 2022 (UTC)