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Background and Aim: The aim of this article was to critically discuss the clinical application of a cognitive behaviour therapy (CBT) protocol for the treatment of hyperacusis and its asso­ciated distress. Methods: Narrative review Recent Findings: Reviewing the research lit­erature suggests that hyperacusis, anxiety and safety seeking behaviours may be linked. Therefore, it seems reasonable to suggest that clinical management of hyperacusis should also include addressing co-existing anxiety and avoidance behaviour. Although, there is strong evidence supporting the effectiveness of CBT in treating anxiety, the studies directly assessing the effect of CBT on hyperacusis are limited. In this paper, the clinical implementation of a CBT protocol for hyperacusis rehabilitation is discussed. Conclusion: Although a causal relationship bet­ween anxiety and hyperacusis is not clear, there is a growing body of evidence suggesting a pos­sible link between them. In the absence of a cure for hyperacusis, treatment of the anxiety component of the condition could be beneficial.