Understanding therapeutic change
NIPRT combines clinical practice with research on psychotherapy processes, development, and training. We study how people change — and how therapists can support that change.
NIPRT Research Lab
A qualitative psychotherapy process research group studying how change happens inside a single treatment — how self-observation, agency and shame develop, and what in the therapeutic dialogue makes that development possible.
The NIPRT Research Lab is the research arm of the Nordic Institute for Psychotherapy and Research in Helsinki. It conducts theory-based single-case and process research on psychotherapeutic change, working from verbatim session material rather than from aggregate outcome measures.
The lab's methodological core is Dialogical Sequence Analysis (DSA) — a microanalytic method for reading how a speaker positions themselves toward both an object and an addressee — used alongside the assimilation model (APES). Work is carried out with an international group of psychotherapy process researchers.
Methods
- Dialogical Sequence Analysis (DSA)
- Assimilation of Problematic Experiences Scale (APES)
- Theory-based single-case research
- Psychotherapy process research
Director of Research
Sami Kivikkokangas, PsL
Director of Research, NIPRT Research Lab
Doctoral Researcher, Doctoral Programme in Clinical Research, University of Helsinki
Psychologist (PsL), training and supervising psychotherapist, and doctoral researcher at the University of Helsinki, where his doctoral work concerns psychotherapeutic change. He teaches and publishes on single-case research and methodology, adolescent development, therapeutic technique and relationship, and the development of agency out of vulnerability and shame, and serves on the boards of several Finnish psychotherapy training programmes.
- Research contact
- sami.kivikkokangas@helsinki.fi
- Academic profiles
- University of Helsinki Research Portal ↗ResearchGate ↗
Research group
The research group works in collaboration with colleagues in Finland and internationally, across psychotherapy process, child and adolescent development, the therapeutic relationship, embodiment, and training.
Co-authors and joint publications — Sami Kivikkokangas on ResearchGate ↗
Research domains
- Process Research — How therapeutic change unfolds moment to moment, traced in single-case process research.
- Child & Adolescent Development — Early disturbance, infant observation, and the formation of adolescent identity.
- Therapeutic Relationship — Vulnerability, shame, and the growth of self-agency through therapeutic encounter.
- Body & Psychic Integration — Embodiment, neuropsychoanalysis, breathing and self-regulation.
- Training & Cross-Cultural Work — How therapeutic skill develops and transfers across cultural contexts.
Supported by
Thinking Machines Lab — Tinker Research and Teaching Grant, 2026 ↗ — Supporting our work on AI-assisted analysis in psychotherapy process research.
“The idea of care is that we try to understand what a person needs.”
— Mikael Leiman
Selected Publications
Kivikkokangas, S., Leiman, M., & Enckell, H. (2026). The development of self-observation as a precondition for self-analysis – the case of Amalia X. Scandinavian Psychoanalytic Review, 49(1), 64–80. DOI
Rita, N. & Leskinen, K.-M. (2025). Särkyneen korjaamisesta: psykoterapeutti sijoitetun ja adoptoidun nuoren matkakumppanina. Psykoterapia, 44(4), 314–327.
Leskinen, K.-M. (2024). Pekka Töpöhännän kadehdittava kyky olla oma itsensä. Psykoterapia, 43(2), 108–.
Nissinen, T. (2023). Olemisen virrassa: tiedostamaton elämä ja tietoinen olemassaolo neurotieteissä ja psykoanalyysissä. Psykoanalyyttinen psykoterapia, 19.
Eubanks, C. F., Samstag, L. W. & Muran, J. C. (Eds.) (2023). Rupture and Repair in Psychotherapy: A Critical Process for Change. APA Books.
Iwakabe, S., Nakamura, K. & Thoma, N. C. (2023). Enhancing emotion regulation. Psychotherapy Research, 33(7), 918–945.
Yli-Pohja, S., Kivikkokangas, S., Luhtavaara, A. & Nissinen, T. (2022). Miten säilyttää kyky ajatella samalla kun…. Psykoanalyyttinen psykoterapia, 18.
Leskinen, K.-M. & Rita, N. (2021). Yhteys vaarassa nuoruuden kynnyksellä. In Yhteys – psykoanalyyttisen ajattelun ytimessä. Prometheus.
Iwakabe, S. (2021). Working with social withdrawal, or hikikomori, in Japan: From shame to pride. Journal of Clinical Psychology, 77(9), 2073–2085.
Kivikkokangas, S., Leiman, M., Laitila, A., & Stiles, W. B. (2020). Hiding shame — a case study of developing agency. Revue roumaine de psychanalyse, 13(1), 85–116.
Kivikkokangas, S., Leiman, M., & Enckell, H. (2020). Itsehavainnoinnin kehittyminen edellytyksenä itseanalyyttiselle funktiolle. Psykoterapia, 39(3), 196–216.
Kivikkokangas, S. (2020). Depressiiviset ja itseään laiminlyövät persoonallisuudet. In Häkkinen, M. (Ed.), Nuorisopsykoterapian erityiskysymyksiä: Mieli, muutos & aika. Nuorisopsykoterapia-säätiö.
Luhtavaara, A. (2020). Kuinka puhumme kun puhumme sukupuolesta. Psykoterapia, 39(2), 138–149.
Luhtavaara, A. (2020). Kielen synty. Psykoanalyyttinen psykoterapia, 16, 46–53.
Kivikkokangas, S., & Leiman, M. (2019). Amalia X: Dialogical sequence analysis as a method in theory-based single case research in psychoanalysis. Scandinavian Psychoanalytic Review, 41(2), 108–118. DOI
Luhtavaara, A. (2019). Naisen vaiettu regressio. Psykoterapia, 38(4), 332–341.
Eubanks, C. F., Muran, J. C. & Safran, J. D. (2018). Alliance rupture repair: A meta-analysis. Psychotherapy, 55(4), 508–519.
Lombardi, R. (2018). Entering one's own life as an aim of clinical psychoanalysis. Journal of the American Psychoanalytic Association, 66(4), 691–711.
Rita, N. et al. (2017). Child and family-related predictors of psychological outcomes in children adopted from abroad. Scandinavian Journal of Psychology, 58(4), 269–349.
Lombardi, R. (2017). Body-Mind Dissociation in Psychoanalysis: Development after Bion. Routledge.
Greenberg, L. S. & Iwakabe, S. (2011). Emotion-focused therapy and shame. In Dearing, R. L. & Tangney, J. P. (Eds.), Shame in the Therapeutic Hour (pp. 69–90). APA.
Lombardi, R. (2009). Through the eye of the needle: The unfolding of the unconscious body. Journal of the American Psychoanalytic Association, 57(1), 61–94.
Research Collaboration
University of Helsinki
Doctoral Programme in Clinical Research, doctoral research
ICATA
International CAT research network
DiaSek ry
Development of DSA research
SPR
Society for Psychotherapy Research