Principles and application of educational counseling used in progressive audiologic tinnitus management.

Exposure to loud sounds is a common cause and exacerbater of tinnitus - a troubling auditory symptom that affects millions of people worldwide. Clinical research at the National Center for Rehabilitative Auditory Research has resulted in a clinical model of tinnitus management referred to as Progressive Audiologic Tinnitus Management (PATM). The model involves five hierarchical levels of management: Triage, Audiologic Evaluation, Group Education, Tinnitus Evaluation, and Individualized Management. Counseling by audiologists and, as needed, mental health providers, is a key component of PATM. This style of counseling focuses less on didactic informational counseling; instead, counseling is used for facilitating patients' learning to adjust to the disturbing auditory symptom by successfully employing tools from two powerful skillsets for self-management of chronic tinnitus - the therapeutic uses of sound and techniques from cognitive-behavioral psychology. This article provides an overview of the methods of counseling used with PATM and provides details concerning the overarching principles of collaborative adult learning that are believed to be most important in facilitating self-management by patients who complain of tinnitus.

Use of mental health services by veterans disabled by auditory disorders.

This study examined whether veterans disabled by auditory disorders face barriers to receipt of Department of Veterans Affairs (VA) mental health services. We compared use of VA mental health services by veterans disabled by auditory disorders with use of such services by veterans disabled by four other chronic illnesses. We hypothesized that disabled veterans with auditory disorders, including tinnitus and/or hearing loss, would be less likely to use VA mental health services than other disabled veterans because of communication difficulties. The study sample was based on national VA administrative data for veterans with a diagnosed mental health disorder who were not receiving VA compensation for that disorder but who were receiving VA compensation for another disorder, either physical or auditory, at the end of fiscal year 2005. After controlling for potentially confounding factors, we unexpectedly found that veterans disabled by auditory disorders were more likely than other disabled veterans to use VA mental health services at least once. Among users, however, those with auditory disorders accessed slightly fewer visits than those disabled by other conditions, although the reasons for the difference remain unclear.