[9] Although no studies have concluded in its optimal treatment[clarification needed], TRT has been used to treat hyperacusis, misophonia, and phonophobia.
[2] Tinnitus may be the result of abnormal neural activity caused by discordant damage (dysfunction) of outer and inner hair cells of the cochlea.
One study[citation needed] found that a full tinnitus masker was just as effective as partial masking, nullifying a key component of habituation therapy.
Confounding factors make it difficult to measure the efficacy of TRT: tinnitus reporting is entirely subjective, varies over time, and repeated evaluations are not consistent.
[citation needed] In many commercial TRT practices, there is a large proportion of dropouts; reported "success" ratios may not take these subjects into account.
There are few available studies, but most show that tinnitus naturally declines over a period of years in a large proportion of subjects surveyed, without any treatment.
A study that compared cognitive behavior therapy (CBT) in combination with the counselling part of TRT versus standard care (ENT, audiologist, maskers, hearing aid) found that the specialized care had a positive effect on quality of life as well as on specific tinnitus metrics.
[12] Tinnitus activities treatment (TAT) is a clinical adaptation of TRT that focuses on four areas: thoughts and emotions, hearing and communication, sleep, and concentration.
The five steps are: The U.S. Department of Veterans Affairs (VA) now employs PTM to help patients self-manage their tinnitus.