Mental health treatment that includes Tetris® gameplay dramatically reduces traumatic flashbacks | News

Remarkable new research has shown that a simple, digital intervention that includes gameplay can dramatically reduce intrusive memories of trauma in a month, even to the point of being symptom-free after six months. Using ‘mental rotation,’ the treatment was also very effective at reducing the symptoms of post-traumatic stress disorder (PTSD) more generally.

The groundbreaking study, funded by Wellcome, offers huge potential to implement a highly scalable, low intensity, easily accessible, digital treatment that could transform how we prevent and treat PTSD for people who have been exposed to trauma worldwide.

The findings, published in The Lancet Psychiatry, are the result of a randomised controlled trial of 99 healthcare workers exposed to trauma at work during the Covid-19 pandemic. After just one month, researchers found a stark reduction in intrusive memories, commonly known as flashbacks, for those using the treatment.

It remained highly effective after six months, with 70% of participants who received it reporting no intrusive memories at all, even alleviating other PTSD symptoms. This promising new digital mental health intervention has been developed at Uppsala University in collaboration with P1vital, and trialled with collaborators including the University of Cambridge, and the University of Oxford.

The global prevalence of trauma

According to the World Health Organization, psychological trauma – exposure to severe injury, death, or sexual violence – affects seven out of 10 of people at least once in their lifetime. Severe trauma can lead to PTSD, experienced by millions of people globally, and often presents as sudden, unwanted intrusive memories accompanied by very distressing emotions.

Existing therapies for PTSD are effective yet remain widely inaccessible. They tend to be resource-intensive requiring multiple sessions with specialists, are widely unavailable, and are not recommended for those facing ongoing trauma.

Healthcare workers are regularly exposed to traumatic events, with limited treatment options often owing to a lack of availability. In the UK, PTSD prevalence among NHS staff increased from 13% before Covid-19 to 25% at the height of the pandemic. Health systems are under increased strain from untreated traumatic stress reactions among health professionals, with poor mental health resulting in people unable to work or leaving the healthcare profession.

Emily Holmes, Professor of Psychology at Uppsala University, and study lead, said:

“Even a single, fleeting intrusive memory of past trauma can exert a powerful impact in daily life by hijacking attention and leaving people at the mercy of unwanted and intrusive emotions. By weakening the intrusive aspect of these sensory memories via this brief visual intervention, people experience fewer trauma images flashing back.

“We are delighted to have made a real breakthrough by showing this intervention works. It is far more than just playing Tetris, and while it is simple to use, it’s been a complicated process to refine and develop. The intervention focuses on our mental imagery, not words, and is designed to be as gentle, brief and practical as possible to fit into people’s busy lives. We hope to expand our research so it can be put into practise by determining its effectiveness for a broader range of people and scenarios.”

Mental rotation and the mind’s eye

The study focused on treating intrusive, vivid and unwanted memories of trauma, a hallmark symptom of PTSD. A research team, combining decades of mental health and trauma research experience, expertise from a world-leading intensive care research unit, and the latest mathematical approaches, undertook a randomised controlled trial to test the effectiveness of a brief digital intervention in healthcare workers during the Covid-19 pandemic.

The treatment – called the ‘Imagery Competing Task Intervention’ (ICTI) and detailed below – has been developed and refined over many years of lab research. One component of this is the video game Tetris®, which involves players rotating differently shaped, geometric blocks as they descend to neatly fit them together into a grid.

In the first step, participants briefly recall the memory, without needing to describe it or go into detail.

Next, they are taught how to use mental rotation, a cognitive skill using the mind’s eye.

ICTI then requires participants to use this skill to play Tetris^®, but in a particular slower way, not typical of normal gameplay.

The ICTI method overall is thought to occupy the brain’s visuospatial areas, therefore competing with the visual flashback, weakening its vividness and emotional impact, and critically, the frequency that it intrudes.

To actively compare against ICTI, one control group of the trial listened to music by Mozart, reputed for therapeutic benefits to alleviate stress, and informational podcasts about him. In a second control group, participants received only standard care.

The results showed that participants receiving the ICTI had 10 times fewer intrusive memories than either control group four weeks after starting the intervention. Encouragingly, ICTI was also highly effective in the long-term. After six months, 70% of participants receiving the treatment reported no intrusive memories at all – a dramatic reduction compared to the control groups.

Participants using ICTI saw vastly improved results in terms of PTSD symptoms, demonstrating a ‘domino effect’ of the intervention to reduce these more generally. This demonstrates highly promising potential.

Tayla McCloud, Research Lead for Digital Mental Health at Wellcome, said:

“These results are impressive for such a simple to use intervention. If we can get similarly strong results in bigger trials, this could have an enormous impact. It’s rare to see something so accessible, scalable and adaptable across contexts. It doesn’t require patients to put their trauma into words and even transcends language barriers. This study is a key example of why Wellcome is investing in a wide range of mental health interventions, so that in the future everyone will have access to treatments that work for them.”

From distressing trauma to meaningful relief

The findings demonstrate that directly targeting the visual imagery component of intrusive memories powerfully lowers their frequency and intensity, and even provides meaningful relief from PTSD more broadly.

Charlotte Summers, Director of the Victor Phillip Dahdaleh Heart & Lung Research Institute, Professor of Intensive Care Medicine at the University of Cambridge, and study co-author, said:

“Every day, healthcare workers across the world are recurrently exposed, to traumatic events in the course of their work, impacting the mental and physical wellbeing of those who care for us when we are unwell.

“At a time when global healthcare systems remain under intense pressure, the discovery of a scalable digital intervention that promotes the wellbeing of health professionals experiencing work-related traumatic events is an exciting step forward.”

Now, the research team are seeking options to test the effectiveness of the treatment with larger, more diverse groups of people, as well as a non-guided version. In doing so, researchers hope to demonstrate how a promising, scalable, globally available, digital intervention could help contribute towards trauma treatment around the world.

Notes to Editors

Research paper
Beckenstrom A.C., Bonsall^,M.B., Markham, A., Slade^,O., Ramineni^,V., Iyadurai, L., Islam^,Z., Highfield^,J., Jaki, T., Goodwin, G.M., Dias, R., Daniels, R., Malik, A., SummersC, Kingslake, J., Holmes, E.A. (2026). A digital imagery-competing task intervention for stopping intrusive memories in trauma-exposed health-care staff during the COVID-19 pandemic in the UK: a Bayesian adaptive randomised clinical trial, The Lancet Psychiatry.

DOI: 10.1016/S2215-0366(25)00397-9 

About Wellcome

Wellcome supports science to solve the urgent health challenges facing everyone. We support discovery research into life, health and wellbeing, and we’re taking on three worldwide health challenges: mental health, infectious disease and climate and health.

About P1vital

P1vital Products Limited is a digital health company specializing in technology-enabled solutions for neuroscience and mental health research. The company delivers innovative digital platforms, including electronic patient-reported outcomes (ePRO) and remote assessment tools, to enable high-quality data capture in clinical trials while supporting mental health research through scientifically grounded, user-focused technology.

About Uppsala University

Uppsala University, Sweden, was founded in 1477 and was the first university in the Nordic countries. Its mission is to gain and disseminate knowledge for the benefit of humankind and a better world.

About the University of Cambridge

The University of Cambridge is one of the world’s leading universities, with a rich history of radical thinking dating back to 1209. Its mission is to contribute to society through the pursuit of education, learning and research at the highest international levels of excellence. 

The University comprises 31 autonomous Colleges and over 100 departments, faculties and institutions. Its 24,000 students include around 8,000 international students. In 2024, 71% of its new undergraduate students were from state schools.

Cambridge research spans almost every discipline, from science, technology, engineering and medicine through to the arts, humanities and social sciences, with multi-disciplinary teams working to address major global challenges. In the Times Higher Education’s rankings based on the UK Research Excellence Framework, the University was rated as the highest scoring institution covering all the major disciplines.

A 2023 report found that the University contributes nearly £30 billion to the UK economy annually and supports more than 86,000 jobs across the UK, including 52,000 in the East of England. For every £1 the University spends, it creates £11.70 of economic impact, and for every £1 million of publicly-funded research income it receives, it generates £12.65 million in economic impact across the UK.

The University sits at the heart of the ‘Cambridge cluster’, in which more than 4,500 knowledge-intensive firms employ more than 75,000 people and generate £25 billion in turnover. 26 billion-dollar businesses have been founded in Cambridge.

About the University of Oxford

Oxford University has been placed number 1 in the Times Higher Education World University Rankings for the tenth year running, and number 3 in the QS World Rankings 2024. At the heart of this success are the twin-pillars of our ground-breaking research and innovation and our distinctive educational offer.

Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research alongside our personalised approach to teaching sparks imaginative and inventive insights and solutions.

Through its research commercialisation arm, Oxford University Innovation, Oxford is the highest university patent filer in the UK and is ranked first in the UK for university spinouts, having created more than 300 new companies since 1988. Over a third of these companies have been created in the past five years. The university is a catalyst for prosperity in Oxfordshire and the United Kingdom, contributing around £16.9 billion to the UK economy in 2021/22, and supports more than 90,400 full time jobs.