3 - (3 MIN 3) Teaching Patients to Respond Differently to Tinnitus: Mindfulness, Habituation, and Behavioral CBT Skills in Embedded Care

Chronic tinnitus is a highly distressing condition associated with heightened anxiety, hypervigilance, sleep disturbance, and functional impairment, often in the absence of clear biomedical resolution. Cognitive behavioral therapy (CBT) is among the most empirically supported treatments for tinnitus-related distress, with growing evidence supporting mindfulness-based attention strategies, habituation-oriented exposure, and behavioral interventions targeting avoidance and safety behaviors (Hesser et al., 2021; McKenna et al., 2021). However, access to structured CBT interventions for tinnitus remains limited in routine otolaryngology care.
To address this gap, an Embedded Behavioral Health Service (EBHS) was developed within a multidisciplinary tinnitus clinic at Mass Eye and Ear Hospital to deliver brief, skills-based CBT interventions integrated alongside medical treatment. This presentation describes the service delivery model and specific evidence-based practices implemented, with the goal of providing a replicable framework for other behavioral health clinicians working in medical settings. Core skills taught to patients include psychoeducation on tinnitus, mindfulness-based attention training to reduce threat-driven monitoring, graded exposure to tinnitus-related sensations and triggers to support habituation, behavioral sleep strategies, and values-consistent re-engagement in daily activities. These interventions are designed to disrupt maladaptive cycles of attentional capture, emotional reactivity, and behavioral avoidance that maintain tinnitus-related distress.
Using a clinical case example, the presentation will illustrate how CBT-informed tinnitus care can be delivered effectively within an embedded model, highlighting practical considerations for interdisciplinary collaboration, session structure, and outcome-focused care. The session will also share implementation insights and lessons learned to support replication and adaptation of this model by other behavioral health practitioners. This work underscores the value of integrating evidence-based psychological care within specialty medical clinics to enhance patient outcomes and promote accessible, scalable tinnitus treatment.