PPPD (Persistent Postural-Perceptual Dizziness) CBT Pathway

Integrate CBT with vestibular therapy

PPPD features chronic subjective dizziness that worsens in busy visual environments or while upright. CBT logs clarify when safety behaviors (grabbing walls, avoiding grocery stores) interfere with vestibular compensation, so rehab specialists can pair exercises with thought work.

Track maladaptive safety patterns

• Balance-safety behaviors: noting cane/grab-bar reliance, rigid posture, or prolonged sitting creates data for gradually fading aids.
• Visual avoidance: log how long you tolerate patterned floors, scrolling screens, or fluorescent lighting before symptoms spike.
• Motion avoidance: capture car rides, elevators, escalators, and head turns to spot missing exposures.

Grounding + gaze stabilization sets

Use journal templates for grounding drills (feet scanning, paced breathing) plus gaze-stabilization tasks (VOR x1, optokinetic tape, head circles). Rate dizziness, anxiety, and confidence pre/post to illustrate improvement trends.

Autonomic regulation + motion hierarchy

Pair motion exposure ladders with autonomic regulation. Example entry: “Grocery store at noon, target 10 minutes, predicted dizziness 7/10, actual 5/10, coping skill = box breathing.” Add muscle relaxation, hydration, and sleep data to show how systemic factors influence symptoms.

Debriefs + care-team coordination

After each exposure, log what helped, what needs coaching, and questions for neurology/ENT follow-up. Summaries make multidisciplinary visits efficient while reinforcing patient self-efficacy.

Product resources

Universities and clinics can provision the CBT journaling app for students; individuals can Download the CBT journaling app and explore CBT journaling app pricing to keep vestibular homework and reflections synced.