Freequency is being developed and evaluated within a growing body of clinical and applied research. This work focuses on understanding its impact on tinnitus-related distress, its underlying mechanisms, and its role within existing tinnitus care pathways. The current evidence base combines clinical evaluation, real-world data, and academic research on user behavior and engagement.
Clinical advisory board:
- Jan de Laat ,PhD, Medical Physicist Audiologist
- Steven C. Hayes, PhD, Clinical Psychologist
- Gerhard Andersson, PhD, Professor of Clinical Psychology
Clinical Rationale and Observed Effects
Freequency is currently being evaluated as part of a long-term, ongoing clinical development trajectory, focusing on changes in tinnitus-related distress over time in adults with chronic tinnitus.
Preliminary observations indicate a measurable reduction in tinnitus-related distress, based on validated patient-reported outcome measures. Users demonstrate consistent improvement patterns, with the largest reductions occurring in the initial phase of use, followed by stabilization over time.
Average reductions of 5–6 points on tinnitus distress scores have been observed within a 90-day period. In users who engage consistently on a daily basis, reductions can reach levels considered clinically meaningful, suggesting that structured and repeated use may enhance therapeutic impact.
Changes are primarily observed in cognitive and emotional domains of tinnitus, rather than in perceived loudness. This pattern aligns with established tinnitus therapies, where reductions in distress are driven by changes in cognitive appraisal, emotional response, and attentional processing, rather than by altering the auditory percept itself. As described in the literature, initial reductions in tinnitus-related distress are consistent with cognitive behavioral approaches, where early improvement is followed by stabilization as new coping strategies are consolidated. This aligns with neurocognitive models of tinnitus, in which distress is mediated by limbic-frontal networks involved in meaning-making and emotional regulation.
Freequency builds on these principles by targeting how tinnitus is processed, rather than the sound itself, supporting habituation through repeated, controlled exposure in a structured environment.
Therapeutic Rationale
Freequency builds on established principles from:
- exposure-based therapy
- cognitive behavioral therapy (CBT)
- mirror therapy (as applied in phantom percept conditions)
By combining these principles in an augmented reality environment, Freequency enables:
- controlled and repeated exposure to tinnitus-like stimuli
- active engagement with the percept
- gradual reduction of threat perception and distress
This approach is consistent with current understanding that habituation is driven by changes in meaning, attention, and emotional response, rather than elimination of the sound itself.
Funded Research & Implementation (NWO SIA KIEM)
Freequency is part of a publicly funded research program: “Freequencies – Applying design power for effective tinnitus treatment” This program integrates:
- clinical insights
- implementation research
- design and behavior science
Key research themes include:
- effectiveness in real-world settings
- usability and acceptance
- integration into healthcare pathways
- scalability and societal impact
Academic Research on Engagement (TU Delft)
Freequency is also studied within academic design research programs, focusing on long-term engagement and user behavior. Research shows that:
- sustained engagement is critical for therapeutic effect
- adherence declines without sufficient feedback and progression
- perceived progress strongly influences continued use
- These insights directly inform ongoing product development and clinical positioning.
Real-World Data (The Netherlands)
Freequency is used at scale in the Netherlands, generating continuous real-world data using validated tinnitus outcome measures. The Tinnitus Functional Index (TFI) is used to collect data from users at 4 different time points in the 100 day journey. This data:
- supports findings from clinical evaluation
- provides insight into variability between users
- informs optimization of both content and experience
Download the clinical assessment white paper of our real world data here
Ongoing and International Research
Ongoing clinical evaluation continues in real-world care settings, focusing on long-term outcomes and implementation.
In parallel, a pilot study in the United States is assessing:
- usability and engagement
- clarity and tone of content
- cultural fit within the US healthcare context
Participants are followed longitudinally using structured feedback moments.