A 20-minute Tetris task delivered remotely reduced intrusive memories by 70% in health care workers exposed to trauma during the COVID-19 pandemic, offering a promising brief intervention for both prevention and treatment.

A randomized controlled trial published in BMC Medicine finds that a brief, remotely delivered intervention using the computer game Tetris significantly reduced intrusive memories and post-traumatic stress symptoms in frontline healthcare workers exposed to work-related trauma during the COVID-19 pandemic.

The study enrolled 164 healthcare workers in Sweden who had experienced at least one traumatic event and reported a minimum of two intrusive memories per week. The mean age was 41.41±10.89 years, and 81.9% were female. Participants had experienced an average of 17.02±21.38 work-related traumatic events during the pandemic, with 72.2% of these events occurring within the previous 1-3 months.

At baseline, the mean post-traumatic stress symptom score was 12.10±6.63 on the PTSD Checklist for DSM-5 (PCL-5) 8-item version. The median number of intrusive memories recorded in a daily diary for one week was 15.00 (IQR=7.5–28.5).

Participants were randomized 1:1 to either the imagery-competing task intervention (n=73) or an attention-based control task (n=71). The intervention involved a brief memory cue followed by 20 minutes of Tetris gameplay with mental rotation instructions. The control group listened to a podcast on philosophy for the same duration. Both tasks were delivered remotely via participants' smartphones.

At five weeks post-intervention, the primary outcome—the number of intrusive memories—was significantly lower in the intervention group compared to the control group (median 1.0 [IQR=0-3] vs 5.0 [IQR=1-17], respectively; IRR=0.30, 95% CI, 0.17–0.53; P<.0001). The intervention group also had fewer intrusive memories at one week (median 4.5 [IQR=2-10.5] vs 11.0 [IQR=3-21]; IRR=0.53, 95% CI, 0.41–0.70; P<.0001) and less severe post-traumatic stress symptoms at 1, 3, and 6 months (all P<.0001).

No serious adverse events were recorded, and the intervention group reported fewer adverse events overall when compared to the control group (64 vs 119, respectively; P=.0052). The intervention was found acceptable, with 80.9% of participants in the intervention group continuing to use the task on their own at one month after the intervention.

This brief, scalable, single-session intervention targets a specific symptom—intrusive memories—and can be delivered from the day of trauma up to months later, making it a versatile tool for both prevention and treatment.

Conflict of interest disclosures and funding information are available in the study.