Audiology & Neuro-otology

Tinnitus Retraining Therapy

An evidence-based program to habituate the brain to chronic tinnitus.

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Tinnitus Retraining Therapy (TRT) is a structured, long-term program that combines directive counseling with sound therapy to retrain how your brain processes tinnitus. Most patients reach meaningful habituation in 12–24 months.

Conditions we treat

  • Chronic subjective tinnitus
  • Hyperacusis and sound sensitivity
  • Tinnitus-related insomnia
  • Tinnitus-related anxiety and avoidance
  • Misophonia (specific protocols)

Our approach

TRT is not a quick fix. It is a neuroscience-grounded program built on the Jastreboff model of tinnitus, delivered by audiologists with formal TRT training:

Directive counseling

Structured education about tinnitus neurophysiology that reduces the threat response driving symptom severity.

Sound therapy

Personalized low-level broadband sound enrichment to weaken the contrast between tinnitus and silence.

Long-term tracking

Quarterly outcome measures (THI, VAS) to confirm habituation is on track.

How it works

  1. 1

    Initial intake

    Hearing history, audiogram review, and TRT category assignment.

  2. 2

    Counseling phase

    Two to four structured counseling sessions over the first month.

  3. 3

    Sound therapy onboarding

    Recommendations for sound generators, hearing aids with masking, or environmental sound.

  4. 4

    Quarterly check-ins

    Brief sessions every three months for 18–24 months.

Is this right for you?

Best for

  • Patients with bothersome tinnitus persisting beyond 6 months
  • Those willing to commit to a multi-year program
  • Patients who have already had ENT clearance

Not the right fit

  • New-onset tinnitus (under 3 months) without ENT evaluation
  • Pulsatile tinnitus without vascular workup
  • Acute Meniere's flares or sudden hearing loss

Frequently asked questions

Will TRT make my tinnitus go away?

TRT is about habituation, not elimination. The goal is for tinnitus to fade into the background — present but no longer distressing or noticed most of the day.

Do I need to wear sound generators all day?

During the active phase, most protocols recommend 6–8 hours per day of low-level sound enrichment. This tapers as habituation progresses.

Is TRT the same as CBT for tinnitus?

They are different evidence-based approaches. TRT emphasizes counseling and sound therapy together. CBT focuses on cognitive and behavioral patterns. Some patients benefit from both.

Can I do TRT entirely online?

Yes. Counseling, outcome tracking, and sound therapy guidance translate well to telehealth. We coordinate with local audiologists for any in-person fittings needed.

Ready to start?

Schedule a free 15-minute discovery call to see if this program fits your needs.