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ADDICTION
‘DDA offers a place and space
where individuals with
comorbidity can finally be
heard by those who identify
with similar experiences.’
where people with dual diagnosis can get their voice heard. Called
Dual Diagnosis Anonymous (DDA), it is free, available in the
community, does not require referral, there is no waiting list –
and most importantly it adopts an integrated approach to
comorbidity. The groups are facilitated with competence and
compassion by John O'Donnell, a peer supporter with many
years of experience in running groups.
DDA-UK was founded by Daniel Ware and Alan Butler, with
the support of the Ealing Councils' commissioners for
addictions, Ealing Council commissioning for mental health and
the clinical commissioning group. Daniel discovered DDA in 2014
on a research trip to Portland, USA, where he was studying
approaches to homelessness and support. Having worked for the last
13 years in frontline homeless services in London, he was familiar with
the lack of specific services and support for those with a dual diagnosis.
‘When I attended the US DDA meeting I was taken aback by the warmth,
energy and positivity in the room,’ he says. ‘People were clearly in a supportive
space which they could not find anywhere else.’
Daniel met DDA's founder Corbett Monica, a Vietnam vet and an
experienced therapist, who was himself in recovery. It all started when
two of Corbett's clients were politely asked not to return to a local
AA meeting as they were ‘too unwell’. In response, Corbett gained
permission from AA and devised the 12 steps ‘plus five’. The extra
five steps related specifically to the mental health aspects of a
dual diagnosis: acknowledging both illnesses, accepting help for
both conditions, understanding the importance of a variety of
interventions, combining illness self-management with peer
supports and spirituality, and working the programme by
helping others.
The programme also includes the Dual Diagnosis Anonymous
workbook, which guides the reader through the 12 plus five steps
with explanations and well thought-through reflective exercises.
The meeting consists of a regular AA-style gathering and an additional
non-compulsory facilitate d workshop to go through the workbook.
The first time that I attended a DDA meeting I immediately sensed how
people felt accepted and free to be themselves, whatever their mental health status
at that moment in time. I was also surprised how diverse the group was, in terms of
age, culture, gender, mental disorders and the addictive behaviours that members
presented with.
During the meeting there were moments of shared sadness but a lot of laughs
too. As the co-founder and peer supporter Alan Butler explains, ‘When people
attend meetings the first thing that becomes apparent is that they are hearing their
own life experience echoed in the words of others. When you attend meetings you
are advised to listen for the similarities – not the differences. In the traditional AA or
NA fellowship people attempt to separate two inseparable conditions, for fear of
judgment and not being accepted. Historically this is something dually diagnosed
sufferers have been asked to do by the statutory services.
‘DDA offers a place and space where individuals with comorbidity can finally be
heard by those who identify with similar experiences,’ he continued. They can talk
of their personal struggles with addictive behaviours as well as of matters such as
positive effects or side effects of medications, the hearing of voices, the clinical
interventions, or their worries and anxieties. Identification is what keeps people
attending self-help groups.’
The initial evaluation is very encouraging. One young DDA member who had
been suffering from psychosis and cannabis misuse said that for the first time she
could identify with other members in the group. She felt that cannabis was not
considered to be problematic by members in traditional NA groups, while the DDA
facilitator, other members and the workbook helped her understand how use could
affect her mental health.
‘I found the workbook and the workshops very helpful, I understand better what
happened to me and I feel free to talk about my medication and how I feel,’ she
said. ‘I have been able to stay clean for several months and I am doing very well
with my studies… The difference in age doesn’t bother me – I think that it’s helpful
to confer with people who have more experience than me. I also find that the
facilitator is very competent and helps me understand what I’m going through.’
There are five meetings happening in London every week and they are inclusive
and open to anyone who is interested in being alcohol/drug free. Family members
and professionals who want to familiarise themselves with the programme are
welcome too. The goal and the challenge now is to make the programme
sustainable throughout London and the UK in the next few years.
Concluding with Alan’s words, ‘The fellowship of DDA is predicated upon hope –
something that is voiced in the words penned by Fyodor Dostoevsky and adopted as
our DDA motto: “To live without hope is to cease to live.”’
Find out more at www.ddauk.org/programs
Dr Raffaella Milani is senior lecturer and course leader for substance use and misuse
studies at the University of West London. More about the university’s courses at:
www.uwl.ac.uk/academic-schools/psychology/subject-areas-and-courses/substance-
use-and-misuse
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