Features, functionality, and acceptability of Internet-based cognitive behavioral therapy for tinnitus in the United States

Objective: Although tinnitus is one of the most commonly reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related to accessibility of care and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence-based interventions are necessary. Internet-based Cognitive Behavioral Therapy (ICBT) demonstrates potential as a means of delivering this support, but is not currently available in the US. This paper discusses the adaptation of an ICBT intervention, originally used in Sweden, Germany and in the UK, for delivery in the US. The aim of this study was to (a) modify the web platform’s features to suit a US population; (b) adapt its functionality to comply with regulatory aspects, and (c) evaluate the credibility and acceptability of the ICBT intervention from the perspective of healthcare professionals and patients with bothersome tinnitus. Materials/Method: Initially the iTerapi ePlatform developed in Sweden was adopted for use in the US. Functional adaptations followed to ensure the platform’s functional and security features complied with both institutional and governmental regulations, and that it was suitable for a US population. Following these adaptations, credibility and acceptance of the materials were evaluated by both healthcare professionals (n = 11) and patients with bothersome tinnitus (n = 8). Results: Software safety and compliance regulatory assessments were met. Healthcare professionals and patients reported favorable acceptance and satisfaction ratings regarding the content, suitability, presentation, usability and exercises provided in the ICBT platform. Modifications to the features and functionality of the platform were made according to user feedback. Conclusions: Ensuring that the ePlatform employed the appropriate features and functionalities for the intended population was essential to developing the Internet-based interventions. The favorable user evaluations indicated that the intervention materials were appropriate for the tinnitus population in the US.