While the efficacy of the NTTP has been demonstrated, it remains an expensive and somewhat time-consuming treatment strategy. A previous study (Karch, Hill, Casto, Nedostup, & Staton, 2014) indicated that a COTS sound therapy may also be an effective way to treat tinnitus. Preliminary analysis of subjective tinnitus measures from Karch (2014) indicates that the NTTP strategies were effective at reducing the negative effects of tinnitus (i.e. reduction in subjective effects of tinnitus as measured by the Tinnitus Reaction Questionnaire (TRQ), tinnitus awareness time, and tinnitus disturbance time). Similar results were seen with a COTS group, with statistically significant differences in pre- and post-treatment measures of TRQ and tinnitus awareness. Analysis of clinical measures associated with tinnitus suggest no differences between pre- and post-treatment on the masking level required to cover tinnitus or the level of loudness discomfort associated with tinnitus for either group. However, due to the small sample size and unequal groups, comparisons between the treatments in the Karch et al. study (2014) should be made cautiously.