Purpose: This clinical focus article describes the development of a novel, remotely delivered counseling program for patients with hyperacusis. For many patients, seeking management of hyperacusis is limited by accessibility and affordability issues of care. By reducing these barriers, remote counseling has the potential to advance hyperacusis care and improve outcomes for many people suffering from hyperacusis.

Method: We created a 4-week remote counseling program that included asynchronous videos, hands-on activities and quizzes, handouts and resources for teaching coping skills and keeping patients engaged, and synchronous discussions for coaching. Weekly content was derived from in-person therapy using hyperacusis activities treatment (HAT) and focused on five relevant topics that included (a) an overview of hyperacusis, tinnitus, hearing, and hearing loss; (b) reactions to hyperacusis and strategies to reduce negative reactions to sounds; (c) thought analysis and restructuring; (d) relaxation techniques and mindfulness; and (e) gradual sound exposure and proper use of hearing protection.

Results: Our remote counseling program, HAT-Online, provides holistic education about hyperacusis, coping strategies to lessen reactions to everyday sounds and challenge thoughts and fears, and management options including customized sound therapy and relaxation exercises.

Conclusion: With implementation of this remote counseling program, our team anticipates gathering early clinical evidence needed to support larger, multisite, future randomized clinical trials that will be designed to more fully evaluate the effectiveness of the remote delivery of HAT's counseling and customized sound therapy components to reduce reactions to hyperacusis.