BACKGROUND
With the inception of Alcoholics Anonymous in 1935, it is now widely known that 12 Step self help support groups have been the source of tremendous healing and recovery for countless people. While some may dispute the tenants of AA, few in the recovery field would argue its results. A wide variety of self help support groups have not only demonstrated their effectiveness, but have also been shown to fill a needed gap in the health services delivery system.

Over the past decade or so, it has become abundantly clear that the majority of persons who suffer from major mental illness have concurrent substance abuse problems. The combination of these two primary diseases has come to be know as “Dual Diagnosis”. The progression of one or more of these diseases leads to a tremendous amount of suffering, or, as is aptly heard in AA/NA meetings...”to jail, institutions, or death”.

TREATMENT/RECOVERY
It is not enough to focus on one or the other illness, for BOTH are primary. We must go beyond the tendencies of the Social Model recovery philosophy that claims successful substance abuse treatment necessarily leads to a cessation of mental illness symptoms. We must also go beyond the tendencies of the Medical Model clinical philosophy that claims successful treatment of mental illness necessarily leads to a cessation of substance abuse. Blending the philosophy of the Social Model of recovery with the clinical philosophy of the Medical Model makes a tremendous difference in successful treatment.. Dual Diagnosis Anonymous (DDA), represents an effort toward building a support group that recognizes the importance of this blending. Embracing the 12 Steps of Recovery, DDA puts a special emphasis on mental illness and the importance of clinical/medical management. It has been difficult, at best, for many people with dual diagnosis to attend traditional 12 step programs for a variety of reasons. Some of these reasons include: a sense of “symptomatic difference” between addicts and alcoholics and dually diagnosed persons. Some symptoms may result in disruptive behaviors during meetings, further alienating the dually diagnosed. Many dually diagnosed people experience increased levels of fear, anxiety and/or paranoia in group settings. Additionally there is a common perception among some more traditional 12 Step members is that medical management represents the “easy way”, and do not consider those individuals who take prescribed medications to be “clean and sober”. For these reasons, the feeling of “not fitting in” at traditional 12 Step meetings is common for many individuals with dual diagnosis. Now there is an alternative. Because DDA recognizes the importance of “fitting in” with other 12 step support group members

THE TWELVE STEPS OF DDA
1. We admitted we were powerless over our dual diagnosis, and that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God, as we understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed, and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

10. Continued to take personal inventory and when we were wrong promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to others who still suffer from the effects of dual diagnosis, and to practice these principles in all our affairs.

The Twelve Steps are reprinted with permission of Alcoholics Anonymous World Services, Inc.
Permission to reprint and adapt the Twelve Steps does not mean that A.A. is in any way
affiliated with this program. A.A. is a program of recovery from alcoholism only -- use of the
Twelve Steps in connection with programs and activities which are patterned after A.A., but
which address other problems, on in any other non A.A. context, does not imply otherwise.


THE 5 STEPS OF DDA
1. We admitted that we had a mental illness, in addition to our substance abuse, and we accepted our dual diagnosis.

2. We became willing to accept help for both of these diseases.

3. We have understood the importance of medication, clinical interventions and therapies, and we have accepted the need for sobriety from alcohol and abstinence from all non-prescribed drugs in our program.

4. We came to believe that when our own efforts were combined with the help of others in the fellowship of DDA, and God, as we understood Him, we would develop healthy drug and alcohol free life styles.

5. We continued to follow the DDA Recovery Program of the Twelve Steps plus Five and we maintained healthy drug and alcohol free lifestyles, and helped others.


HOW MEETINGS WORK
Meetings of DDA are very much like traditional 12 Step meetings. While there is no “leader”, it is helpful to have an experienced DDAer, or trained professional present who possesses an experiential understanding of 12 Step programs and/or recognizes the benefits of these programs. While this person does not necessarily “run” the meetings, for effective meetings run themselves, s/he can gently re-focus the meeting if necessary to keep it focussed and on track.


Corbett Monica is the Founder of DDA and Executive Director of Dual Diagnosis Anonymous of Oregon, Inc.

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