Tinnitus Retraining Therapy
Drs. Pawel and Margaret Jastreboff reported using Tinnitus Retraining Therapy (TRT) to provide treatment for misophonia.[i] There are many audiologists trained in TRT. Some only treat tinnitus and hyperacusis and some also treat misophonia. TRT uses positive sound protocols, noise generators, and counseling. This is similar to the Misophonia Management Protocol (MMP), except the MMP does not use the positive sound protocols. A journal article reported the treatment of 184 individuals with misophonia. Of this group, 152 individuals (83%) “showed significant improvement.” Significant improvement was defined as at least a two-point reduction on a zero to ten scale to the question, “How much of a problem is your misophonia?” Based on the data reported, I cannot tell if this treatment is more effective than the Misophonia Management Protocol reviewed in the previous chapter. There is a well-established issue with self-report data of this type, especially when the change reported is small. Patients are unconsciously influenced to give answers that are expected, so if a patient wants to get better and the doctor wants them to get better, this can influence the patient’s answer.[ii] This same bias exists with my patients or anyone’s patients, but it is a larger issue when the change due to treatment is small. Nevertheless, it is hopeful that the treatment had a positive effect on many of the individuals, and I look forward to further information about the effectiveness of TRT treatment and the benefits of the individual components.
[i] Jastreboff & Jastreboff, 2014.
[ii] Howard, 1980; Van de Mortel, 2008