History of depression and anxiety

This is the case that I’m working on: Nicole is a 15-year-old Caucasian and identifies as pansexual. She is in her first trimester and just learned she was pregnant. She remarks there is a good possibility her unborn child was exposed to Meth as she was using it (frequently) until she learned she was pregnant. She believes the father of the baby is Jose, a 21-year-old drug dealer who recently was caught selling and prosecuted. He was sentenced to 20 years in jail with the possibility of parole in 15 years. He begged Nicole not to leave him and to keep writing/visiting him as he wants to be there for her and be the proud father of the baby.

Their relationship bordered on abuse (Jose would oftentimes assault Nicole when using). Nicole reports she ran away from her family of origin at age 12 because her father was an alcoholic and her mother too scared to leave or help her. She was sexually molested by her father at age 5. She ran away when the sexual abuse and yelling and level of violence in her family became unbearable. She lived on the streets, prostituting herself for money and shelter when she met Jose. He promised to take care of her by providing shelter, food and drugs. Nicole isn’t sure she in love with Jose because she has developed feelings for another resident at Big Hearts. She is conflicted because she is uncertain if the other resident feels the same way about her, as she does them.

Nicole has a history of depression and anxiety. Sometimes her anxiety gets the best of her and she experiences full-blown panic attacks. When she feels her anxiety getting out of control she freezes and paralyzes. She remarks she cannot think, concentrate, or problem-solve. She just freezes. Nicole believes her panic comes from fears of uncertainty–like her future at the moment. She begins to think about her future and she “freaks out (has full-blown panic attacks, crying, feeling desperate, feeling like her life is going nowhere or her situation is hopeless).” She remarks that the reason she has a hard time making decisions and sticking by the ones she’s agreed to is that she doesn’t want to admit she could make a bad decision. She gets confused easily and overwhelmed; especially when people confront her or question her decisions. For example, she told Jose she loved him and will be there for him when he is released from jail however, she isn’t really certain she would do that and just told him so in order not to have to deal with him. Nicole “hates confrontation”.

Nicole tells Big Hearts she wants to keep the baby. She also has told staff she wants to give it up for adoption. She becomes very confused when the staff begins to discuss options. Nicole states she wants to get her GED and also earn a college degree. She says she believes God will provide for her and always has. She doesn’t go to church however or identify with a specific religion. Nicole seems to say whatever she thinks the other person wants to hear.

How to prepare Treatment Plan? What is the first goal and what is the second goal in this case? What is each goals objective