When you are really struggling with tinnitus you might find you need professional support. This is where Tinnitus Specialists and Hearing Therapists can help.

Tinnitus Specialists are mostly Audiologists or ENT doctors with additional training and qualifications in tinnitus assessment, diagnosis and treatment management. Whilst there may be a Tinnitus Specialist based in your local NHS Audiology Department, you will also find them working in private practices in the community.

A Tinnitus Specialist can perform a series of tests to diagnose or assess your tinnitus and your hearing. Around 80% of people with tinnitus will have a hearing loss, and if this is supported by hearing technology, it can help to relieve some of the symptoms and problems tinnitus can cause.

If you haven't yet had a tinnitus assessment or a hearing loss assessment, your local NHS Audiology service might be a good place to start. Your GP will refer you. This means that the GP will pay for the assessment. If you prefer to see an Audiologist or Tinnitus Specialist privately, you will have to pay for this service. Some health insurance companies will include tinnitus in their provision, so if you have private healthcare insurance, it might be worth asking if your company covers tinnitus assessments and treatments.

You can find adverts for your local independent Audiologist or Tinnitus Specialist online, or by looking at the BSHAA or AiHPP websites. These are professional bodies for private Audiologists in the UK. All Independent Audiologists have to be registered with the HCPC. You can check the list of registered audiologists here.

You are likely to start with a discussion about your medical history. They will need to know if you have had any accidents, injuries or illnesses to your head or ears. These are important factors as all of them could indicate the possible cause or reason for your tinnitus, although its often virtually impossible to be absolutely certain of a cause or reason. Sometimes there just isn't one, as tinnitus is complicated and can be a result of a combination of various factors, conditions and events.

You will be asked about any medications you take regularly, or if you had any life saving treatments like major antibiotics for meningitis etc. or if you have diabetes, high blood pressure or any other medical factors.

They will examine your ears; looking specifically for earwax blockages as this can make your tinnitus worse or louder, and for any damage to the ear canal or eardrum. All of these issues can increase a hearing difficulty, which in turn could make you hear your tinnitus louder.

They are likely to perform some hearing tests, and may undertake some tinnitus assessment listening tests. This is to discover how loudly you perceive your tinnitus, and what kind of noise you hear. It's really hard for most people to describe the noise they hear, and often the sounds played in the tests aren't quite like your tinnitus noise. The purpose is to get an idea of the type of noise your tinnitus is and how loud it is. This is part of the diagnostic testing procedures, so is not always done in treatment planning. This will allow the Audiologist to prescribe a hearing aid, if appropriate, with a masking sound generator programme, matched to your hearing levels and tinnitus pitch.

Originally, Hearing Therapists were a separate complementary profession to audiology. They were trained to work with people requiring additional support to just hearing aid provision. Nowadays, most Hearing Therapists are Audiologists with additional training in adult hearing rehabilitation and tinnitus management. In the UK, most work in NHS Audiology Departments. The Hearing Therapist may assess your tinnitus using a standardised questionnaire such as the Tinnitus Handicap Index or the Tinnitus Functional Index. This will tell the Hearing Therapist how much your tinnitus affects your daily life, and provides a basis for treatment planning and to measure your progress and improvement.

Hearing Therapists are sometimes trained in Tinnitus Retraining Therapy, and other Tinnitus Management techniques. Some Hearing Therapists may be able to offer CBT sessions, or will work alongside the Psychology Department of a hospital to provide this service. Many Hearing Therapists facilitate Tinnitus Support Groups. Being able to share what's happening to you with others who have the same or similar experiences as yourself can be very helpful.

A few Hearing Therapists work in private practices. Many of these Therapists will have training in counselling techniques and technology, as well as often more in depth tinnitus specific training. The therapy that Oto provides is designed by a Hearing Therapist who works in a private practice with nearly 40 years experience.

Whether you decide to go via the NHS route or make an appointment with a private practitioner, you should get time with a specialist who understands tinnitus. They will be able answer your questions and offer you a range of options, as well as develop a personal plan for you.

If you choose the NHS route you will have to wait for treatment, but it will not cost you anything. If you decide to go to a private practitioner, be aware that you could be charged for each appointment or for the treatment plan, so make sure you know how they charge for their services. You are likely to be offered a free or less expensive, first consultation to work out what you are looking for, and what they can provide.

In all cases, the NICE guidelines state that "The evidence suggests that cognitive behavioural therapy (CBT), mindfulness-based CBT and acceptance and commitment therapy (ACT) are effective interventions for managing tinnitus related distress."

Oto was developed to help people avoid the high costs that can be involved in private therapy and the long waits that are often part of the NHS referral system.