Case Conceptualization for Nik Jones: Using Acceptance and Commitment Therapy (ACT)

Running head: CASE CONCEPTUALIZATION 1
Case Conceptualization
Name
Institution

CASE CONCEPTUALIZATION 2
Part I: The Case Study
Patient Name: Nik Jones | Age: 40 | Sex: Male
Race: Caucasian | Relationship Status: Separated from wife
- History and Background Information
A: Identifying Information
Nik Jones is a 40-year-old Caucasian man who identifies as heterosexual. He identifies himself
as able-bodied but has a hard time managing his ADHD, anger, anxiety, and reactive depression.
He has a five-year-old daughter from his marriage. He is separated from his wife of 7 years; she
moved out in October 2016. He resides in the same home that he shared with his wife and in the
same building where his girlfriend lives in Chicago. He was referred for individual therapy
treatment by his couple’s therapist (that he sees with his girlfriend).
B: Presentation/Behavioral Observations
Nik Jones is not on time for most of his sessions; often in a rush; arrives with anxiety. He is well-
groomed, and his dress is appropriate. He has clear speech that is at a steady rate with decreased
volume at times. He tends to avoid eye contact during the sessions and crosses his arms at times.
He maintains good cognitive processes and is oriented to person, place, and time.
C: Presenting Problem(s)
Nik Jones came to therapy because of anger outbursts, anxiety issues and unresolved emotions
regarding his current life situations. His wife continually threatens using their daughter. He
stated that she uses power to trigger his anxiety. He feels emasculated and is afraid of her. He is
dealing with the stressful legal issues that relate to the business he owns. He admitted that he had
thoughts of wanting to escape from all of his problems.
D: History of the Presenting Problem(s)
Nik Jones reports that he and his wife have been married since 9/2011 and dated for 3years
before getting married. He stated the wife became closed off when she had her mother move in
from Russia soon after they moved into their new home he bought; the wife was six months
pregnant (summer 2013). During the time that they all lived together (about 4years), Nik Jones
indicated that his wife and mother-in-law avoided him and isolated him; constantly fought with
him and shouted at him. He and the wife started to drift apart; they began to argue violently each
time they saw one another. He noted she protected her mother. He would extend his business
trips or stay “hidden” in his garage till the morning hours just to avoid going home. He stated
that “if the mother-in-law had not moved-in then everything would have been fine.”

CASE CONCEPTUALIZATION 3
Nik Jones noted his legal issues caused unforeseen stress and he had no support. He and the wife
did not agree on household items and decisions surrounding their daughter (the mother-in-law
took over the household; dictated the schedule for his daughter; did not allow him around his
daughter). The wife showed no interest in providing the time to communicate. He felt both the
wife and mother-in-law became emotionally abusive towards him, and the wife did not take his
side. He reported that he gave up and agreed to her moving out with her mother was the best
solution. The constant fighting became out of control; some of the fights became physical and
extremely disruptive (to their daughter and neighbors).
Nik Jones reported that he became depressed when the wife and mother-in-law moved out with
his daughter because he felt he had nothing. He expressed that he had worked very hard to
provided quality and a lavish lifestyle for his family and was not appreciated. He felt helpless
and misunderstood; wanted to just end things; he would sleep for days on and hide in bed. He
recalls only remembering increasing his prescription of Adderall to stay alert and numb.
- Psychosocial History
A: Family History
Nik Jones grew up with his mother, father, a brother who is 37 and a sister who is 35. He is the
oldest of 3 siblings. They grew up in an affluent town in Kansas City where neighbors held high
powerful positions in business, including his father. He said that they had a “typical” upbringing
(i.e., family vacations, parents with high academic expectations, family parties/gatherings).
Nik Jones stated that his dad changed when he was undergoing a law-sue. He stated that he hated
coming home during this period and being in the house because the father’s behaviors were
uncertain; at times erratic and aggressive towards his mom. He reported that he would hear his
parents arguing during this period and sometimes would hide in his room because it caused him
anxiety. He clarified that he felt this way because his dad would be screaming, his mom would
be crying, and sometimes he would hear loud thumps or things being thrown. He felt helpless not
being able to protect his mom.
Nik Jones noted that he has always had a great relationship with his mom and they talk
frequently. He stated that his mom and dad were supportive when he told them about the
separation (from his wife and child). He stated they drove from Kansas City to help during a
fight he had with his wife that resulted in a physical altercation (Spring 2017). He expressed that
the past 3years have been very stressful dealing with the separation and not having his entire
family close by has been hard. Nik Jones stated that he and his siblings were very close, but now
the brother lives in Dubai and the sister in Paris. He noted that he has not been as constant with
communications with them due to the distance and the shame he has regarding personal issues
that have been unresolved for so long.
Nik Jones expressed that his 5year old daughter, Kyle, is his world. He expressed that he had a
challenging time gaining access to his daughter during the initial separation period. He noted his
current girlfriend gave him the strength and support to fight for his rights and the time with Kyle.
He stated that she just began kindergarten at a British private school in Chicago and could not be
happier to be in school. He stated that his mom helps out a lot with taking care of Kyle by
sending weekly gifts and his girlfriend often prepares food for Kyle.

CASE CONCEPTUALIZATION 4
B: Developmental and Social History
Nik Jones indicated he has a hard time maintaining quality friendships due to lack of time
management and his forgetfulness to follow up with friends. He often feels alone. Nik Jones
stated that he dated a variety of women in his youth and at one point lived in Brazil to run a
business. He reported several romantic long-distance relationships; history of intimate
relationships is often with females who are not available to him emotionally.
After receiving his MBA from Northwestern he stayed in Chicago which is where he met his
wife. He said that the wife was her ideal mate at first and could not have been happier to be with
her. He also noted that they moved in within six months and barely saw one another for the next
3years but only on weekends due to a consulting job that demanded the wife to be out of town
Sunday to Thursday weekly. He explained that he asked for her hand because he felt the time
was right in his life. However, now he expresses that this was one of the worst decisions he ever
made.
Nik Jones notes he had two affairs after he was married. Both women were out of State; one he
was involved with emotionally and sexually for 2.5 years; the other was emotional for about 1.5
years. He stated his wife did not provide him the emotional comfort in their marriage and he felt
isolated throughout the marriage.
Nik Jones stated that he met his current girlfriend in the neighborhood then saw her a year later
at “their building.” He noted feeling alive again meeting a smart and unique woman; he pursued
her, but she showed no interest at first; they connected romantically after establishing a
friendship throughout four months. He stated that his girlfriend is supportive, loving, warm and
communicative. He explained that the girlfriend is like his “best friend” because she is always
there for him and never judges. He stated she comes from a great family whom he has met many
times throughout this past year. He noted that she has not met or spoken to any of his family
members and the wife does not know for sure if they are dating.
C: Abuse/Trauma History
Nik Jones does not report any other abuse other than what is noted above. He did note during
boarding school he was bullied. On one incident he was severely beaten up, locked in a bathroom
stall, and sprayed with cold water (during a cold winter morning). He fell sick and on bed rest for
a week with a high fever. He noted he was not cared for at the boarding school.
D: Educational/Academic History
Nik Jones was sent to a private British boarding school during his youth in Switzerland than in
London. He graduated with a BA in Business then move on to pursue a master's degree and an
MBA at outstanding IVY League Universities (The Wharton School and Northwestern
University). He reported that his passion to be an innovator. He played football and ran track and
excelled in both in high school. He stated that he received a full academic scholarship to college
and was involved in various student organizations in college.
E: Employment History
Nik Jones is an entrepreneur and is currently involved in a couple of medical device projects that
are associated with the FDA. He works from his home office. He explained that he has never had