London, UK – July 18, 2025 – A new article published in The Hearing Review applies a Hegelian lens to the future of tinnitus care in the UK, arguing that audiologist-delivered Cognitive Behavioural Therapy (CBT) represents the necessary resolution to the contradictions in the current system.

The paper, “A Perfect Guideline for an Imperfect System: Tinnitus Care and the NICE Paradox”, critiques the gap between the 2020 NICE guideline for tinnitus management—which strongly recommends CBT—and the lived reality that only a fraction of patients are able to access it.

Adopting a Hegelian framework of teleology and dialectics, the article argues that the contradiction between a rational guideline and an irrational system must be resolved by recognising the evolving therapeutic role of audiologists.

“Patients with tinnitus naturally present to audiologists, not psychologists. If CBT is the most effective intervention, then audiologist-delivered CBT is the dialectical answer that transforms what is rational into what is real.”

The article presents growing evidence that audiologist-delivered CBT is safe, effective, and acceptable to patients:

• Randomised controlled trials of audiologist-guided internet-based CBT show lasting reductions in tinnitus distress, insomnia, and negative thinking.

• NHS service evaluations report high patient satisfaction and significant clinical improvements across tinnitus, hyperacusis, and comorbid conditions.

• Patient-reported outcomes affirm that CBT delivered by audiologists is meaningful and valued in real-world practice.

From a Hegelian perspective, the NICE guideline can be seen as the rational blueprint for tinnitus care, while the failure of implementation exposes the contradictions of workforce assumptions and service design. The resolution, the article contends, is to embrace audiologist-delivered CBT as a scalable model that finally unites rational recommendation with clinical reality.

The full article is available in The Hearing Review: Read here.

About CBT-Hear™
CBT-Hear™ is a professional certification programme in audiologist-delivered CBT, hosted by Hashir International Specialist Clinics and Research Institute for Misophonia, Tinnitus & Hyperacusis. The programme equips audiologists worldwide with the skills and supervision needed to deliver evidence-based CBT for tinnitus, hyperacusis, and misophonia.