Tinnitus Retraining Therapy combines directive counselling with continuous low-level sound enrichment over 12 to 24 months. The goal is habituation: the brain reclassifies the tinnitus as unimportant and stops routing it to conscious attention. It does not make the sound quieter - it makes you stop noticing it.
That distinction is the whole point of the programme. People who pursue silence tend to monitor their tinnitus constantly, which strengthens exactly the attention pathway TRT is trying to weaken.
How the programme works
- 1
Assessment and categorisation
A full tinnitus assessment establishes your hearing thresholds, tinnitus match and THI score, and identifies whether hyperacusis or hearing loss is also present.
- 2
Directive counselling
Structured sessions explaining the mechanism behind your tinnitus. Understanding why the sound exists reduces the threat response that keeps attention locked onto it.
- 3
Sound enrichment
Continuous low-level sound, set just below your tinnitus, is used throughout the day so the auditory system has something else to work with.
- 4
Review at 3 and 6 months
Progress is measured with a repeat THI score rather than by asking whether it feels quieter, which is unreliable.
- 5
Consolidation to 24 months
Sound enrichment is gradually reduced as habituation establishes, with review appointments to keep the programme on track.
TRT compared with the alternatives
| Approach | Target | Timescale | Best for |
|---|---|---|---|
| TRT | Habituation to the sound | 12-24 months | Persistent, intrusive tinnitus |
| Sound therapy alone | Reducing contrast and intrusiveness | Weeks to months | Mild to moderate intrusiveness |
| Hearing aids | Restoring missing input | 4-12 weeks | Tinnitus with hearing loss |
| CBT | Distress, anxiety and sleep | 6-12 sessions | Tinnitus causing low mood or insomnia |
These are not mutually exclusive. The most common combination in practice is hearing aids with a built-in sound generator alongside the counselling element of TRT.
What TRT asks of you
TRT is a commitment. It requires consistent daily sound enrichment, attendance at review appointments, and patience through a period where nothing obvious seems to be happening. People who complete it do well; people who abandon it at month two do not.
If that sounds like more than you need right now, start with sound therapy for tinnitus and reassess after a few months. Either route begins with a tinnitus assessment in Aylesbury.
Frequently asked questions
Clinical References & Sources
- NICE CKS (2024). Tinnitus: management. cks.nice.org.uk
- Tinnitus UK. Tinnitus retraining therapy. tinnitus.org.uk
- NHS (2023). Tinnitus treatment. nhs.uk
- RNID. Living with tinnitus. rnid.org.uk
Reviewed 27 July 2026. Next scheduled review: September 2026.