Regulating Emotional Intensity Through Language: A Mechanistic Case Study of Code-Switching in Prolonged Exposure Therapy.

This article focuses on the integration of guided code-switching into Prolonged Exposure Therapy (PET) as a culturally responsive adaptation for bilingual clients with Posttraumatic Stress Disorder (PTSD). The case study of "Julia," a bilingual Latina survivor of childhood sexual abuse, illustrates how switching between Spanish (the language of trauma) and English (her dominant language) during therapy helped regulate emotional distress while maintaining exposure efficacy. Julia’s treatment with code-switching PET (CS-PET) led to significant reductions in PTSD, anxiety, and depression symptoms, ultimately resulting in remission. The study highlights clinical recommendations for assessing language-related emotional processing, collaboratively establishing distress thresholds for switching languages, and monitoring language use to preserve therapeutic fidelity, while calling for further research on the generalizability and mechanisms of CS-PET in bilingual populations.