Tinnitus retraining therapy (TRT) combines counselling with low-level sound. The aim is for tinnitus to draw less attention and interfere less with everyday life over time. You may still hear the ringing while finding it easier to finish a task, read in a quiet room, or settle at night.
If you’re considering a programme, ask what it includes, how progress will be measured, and what you’ll pay for visits and any devices. The NHS notes that it’s unclear how well TRT works for everyone.
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What Does Tinnitus Retraining Therapy Involve?
TRT has two parts. Counselling helps you understand tinnitus and discuss how you respond when it draws your attention. Sound therapy introduces low-level sound. A clinician may discuss a wearable sound generator or, when you also have hearing loss, a device that combines amplification and sound generation.
The word you may hear during an appointment is habituation. In this context, it means becoming less distracted or distressed by the sound over time. If ringing regularly interrupts your reading, for example, one way to judge progress is whether you can finish a chapter with fewer interruptions.
Start with a description of what you want to do more easily. If you also miss words in conversation, bring that up so the audiologist can address both concerns. See what happens during a hearing test.
How Does TRT Compare With CBT or White Noise?
The approaches can overlap in what they aim to improve. They differ in what you do and what support you receive.
| Approach | What it involves | What to ask |
|---|---|---|
| Tinnitus retraining therapy | Counselling paired with a plan for using low-level sound. | Who provides the counselling, and how will the sound setup be adjusted? |
| Cognitive behavioural therapy (CBT) | Working on thoughts and behaviours that contribute to tinnitus distress. | Does the therapist work with people who have tinnitus? |
| Background sound at home | Trying a fan, soft audio, or another comfortable sound in a specific setting. | Does it help with the activity I chose, such as settling at bedtime? |
| Hearing aids | Amplifying everyday sounds when hearing loss is present. Some devices also offer a sound program. | How will we assess speech understanding and tinnitus separately during a trial? |
For more detail, read about CBT for tinnitus, white noise for tinnitus, or hearing aids for tinnitus.
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What Should You Ask Before Paying for a Programme?
Give the provider one example of how tinnitus affects you. “I notice it when I wake at night, then spend a long time trying to get back to sleep” gives you a specific outcome to discuss.
- What does the price include? Ask about the initial assessment, counselling, follow-up visits, and any equipment.
- Will I need to buy a device? Ask what it does, whether you can try it first, and what the return terms are.
- How will we measure progress? Agree on a goal that matters to you, such as returning to a task more easily after you notice the ringing.
- When will we review the plan? Ask what happens if the sound is uncomfortable or if the programme is doing little for the difficulty you described.
If bedtime is the main concern, describe whether the sound delays sleep or becomes intrusive after you wake. See our guide to sleeping with tinnitus.
When to Get the Ear Symptoms Assessed First
Arrange a medical appointment if tinnitus keeps returning, gets worse, or disrupts sleep or concentration. If the sound beats in time with your pulse, arrange an urgent medical appointment and describe that rhythm when booking. Read about pulsatile tinnitus.
Seek emergency medical care if tinnitus occurs with sudden hearing loss, facial weakness, or spinning dizziness, or if it starts after a head injury. Read about sudden hearing loss.
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