ACKNOWLEDGEMENTS

 

Grateful acknowledgment is due to the following individuals and organizations whose support, encouragement and resources have made this manual possible.

 

Countless survivors of the mental health system, working towards their own recovery, whose experience, perseverance, courage and struggle make up the heart and soul of this booklet.

 

Edward K.

For his help in starting Double Trouble in Recovery

Carolyn P.

a friend and colleague who provided support over the years

David N.

freelance writer and dear friend, who has helped from the very beginning in the development of Double Trouble in Recovery


This booklet was prepared by

Howard V.
Executive Director of Double Trouble in Recovery, Inc.

 

 


For additional copies, contact:

 

Double Trouble in Recovery, Inc.
DTR
PO BOX 245055
Brooklyn, New York 11224

718-373-2684 (sometimes it is on as a fax, sometimes as a phone. If you don\'t get through try again at another time.)
© 1993, 1997 Double Trouble in Recovery, Inc.

 

Key Words and Terms

Preface

Welcome to the World of Double Trouble in Recovery

Dealing with Alcoholism and a Mental Disorder As Well

What is Double Trouble in Recovery?

Why Self-Help Works: Five Reasons

Why a Separate 12-Step Group?

How Does DTR Work?

What Can Double Trouble in Recovery Do For You?

What DTR Does Not Do

How to Start and Run a DTR Group

Publicity Flier (Master Copy)

News Release Form

DTR Brochure (Double Sided Master Copy)

DTR Meeting Format

DTR Meeting Format (description)
Chairperson Format

DTR Group Readings

Serenity Prayer
Preamble
How It Works
12 Steps for DTR
Promises
On Recovery

Additional Group Aspects to Consider

How is the Group Doing?
Some Dangers to Avoid in Self_Help
Challenges Groups Face

The Twelve Traditions of DTR

The Twelve Traditions of AA
The Twelve Traditions of DTR
Introduction to the Traditions
Traditions One through Twelve

Pamphlet for Professionals

Sponsorship

Materials and Supplies

 

 

KEY WORDS AND TERMS

The following words and terms are used in this booklet or in the field
of recovery from mental disorders and chemical addictions.

 

Anonymity

Anonymity is the spiritual foundation of Double Trouble in Recovery. What it means is that the names of people at a meeting and the subjects discussed are traditionally left in the meeting room where they belong and not taken outside. We ask that you respect our anonymity both as alcoholics and people with mental disorders.

 

Dual Diagnosis

A diagnosis involving a mental disorder such as depression or schizophrenia and an addiction to alcohol or street drugs.

 

Peer Support

People supporting each other around a common, shared problem.

 

Recipient of Services

An individual who uses or has used services of the mental health system. (Other similar terms are "consumer of services," "psychiatric survivor," "patient" or "ex-patient.")

 

Recovery

The process of gaining mastery over a mental disorder or addiction according to one’s capacity to do so.

 

Self-Esteem

How you feel about yourself, whether positive or negative.

 

Self-Help

Taking steps to help yourself gain control of your life usually with peer support in a group setting.

 

Stigma

The prejudiced belief that people with a mental disorder are "crazy," "dangerous," incapable of taking care of their own needs, helpless and unacceptable. (Often people with a mental disorder take in and allow stigmatizing attitudes of others to determine how they feel about themselves; this is called "internalized stigma.")

 

 

Preface

Double Trouble in Recovery is designed to meet the needs of the dually-diagnosed and is clearly for those having addictive substance problems as well as having been diagnosed with mental disorders. It is a fellowship founded upon equality, one dually-diagnosed person talking to, never down to, another. This manual has been designed to help start and run a Double Trouble in Recovery group. We share our experience, strengths and hope with each other so that we may solve our common problems and help others to recover from their particular addictions and mental disorders. We who are dually-diagnosed are compelled to walk a long and narrow path. We band together for common good in recovery. This manual has been designed with an open mind and understanding of each other so that we can honestly expose our problems and weaknesses. The humility we show shall never mask the courage it takes to admit who we are as together we find the hope and strengths that make our narrow path into a wide road that leads to peace, serenity and a meaningful life. We regard our fellowship as one dually-diagnosed fellow and human being helping another.

 

Recovery is a lifelong process which does not end when our fellows are discharged from formal treatment. Let those healthcare providers who read this manual understand that we work with fellows of Double Trouble to support the recovery process and that the greatest contribution providers can make in affecting change is in supporting the initiatives of our fellowship. In no way should healthcare providers start or run a Double Trouble group. For then, it would no longer be a self-help group, as Double Trouble provides a place for those of us who are dually-diagnosed, our own mutual aid support group.

 

This manual has been designed for groups to be started and to run so that we might find a helping and healing environment to free us from our affliction and bondage. It is a kind of service that we perform in our fellowship, a service which has been so freely given to us that we have learned that giving of ourselves required effort and time; we have learned not to govern, not to judge, not to play politics and not to gossip. We share our experience, we give praise and learn to be slow to condemn. Those of us in recovery are sometimes close-minded and it is the reason why we find our spiritual teaching difficult, not wanting to find out much about ourselves. We have seen that tolerance expresses itself in a variety of ways, in kindness and consideration toward the man or woman who is just beginning along their path of recovery, in understanding of those who, perhaps, have been less fortunate, and in empathy toward those whose ideas may seem to be at great variance with our own. Without these spiritual principles, we don’t believe that the type of giving we offer each other could keep anybody clean, sober and out of the hospital; but giving of our effort, strength and time in service is quite a different matter.

So for anyone reading this manual, please bear these ideas in mind, that we are servants of our fellowship and that none of us are here to govern or control, but to share in our fellowship. Many of us have never had that flash of light, the spiritual experience. Rather it is a process of spiritual growth, a new awakening. We all seek inner peace, sanity and serenity, and we must practice in order to be good at it. We cannot do anything well in this world unless we practice it; and so we practice these principles in our lives.

 

So, in reading this manual, we attempt to acquire the spirit of service. We attempt to acquire some faith and hope, which isn’t easily done, especially for those of us who have been stigmatized. Please remember to come to some of these ideas and before starting a group, know what you are doing it for, which is not only for Self but for others in recovery.

 

The Second Tradition of Alcoholics Anonymous states:

"For our group purpose, there is but one ultimate authority,
a loving God, as he may express Himself in our group conscience.
Our leaders are but trusted servants, they do not govern."

Good luck and God bless,

 

Howie

 

 

 


 

 

 

 

 

 

 

by Howie V.

 

This letter came to us. It was signed by Andy.  "I am a recovering alcoholic. I hear and see things too. I am in Alcoholics Anonymous, and have admitted I am powerless over alcohol and my mental disorder, like the program’s First Step suggests. I am sober, but I still hear voices talking to me always. Other members of AA don’t have these experiences and I feel alone. They tell me to "let go and let God," and I feel I have tried very hard to, but it just doesn’t help. I must have done something terribly wrong to have these voices for eight years. I must be viewed in an unfavorable light by God. I must have many sins in my soul. I wish so much that there was somewhere to go where others have experienced these problems…."

 

There is such a place.

 

I write this article for Andy, and the rest of the people like us.

Double Trouble in Recovery is a special interest meeting that has been adapted from the Twelve Step program. It is a fellowship for men and women who share their experience and hope with one another so that they may solve their common problems and help each other recover from their addiction and mental disorders. DTR specifically embraces those alcohol / drug users who have a diagnosis of a mental disorder.

 

Due to their dual impairment, recipients find it easier to engage in this type of adapted Twelve Step program because they are all battling common problems not dealt with in regular Twelve Step meetings. It is my firm belief that this type of group is a breakthrough that is working for us. It is a missing link, because too many of us find other Twelve Step fellowship meetings bewildering, anxiety-provoking experiences difficult to endure. It also provides an environment to the newcomer in which issues of medication and mental disorders can be dealt with openly. It encourages recovery instead of active addiction and hospitalization.

 

A common thread in self-help is how peers help people grow toward self-identity and self-purpose. That is closely linked to a need to attain social competence. The type of environment and structure offered to the member can help toward a higher level of functioning. Peers teach each other concrete social skills and return a person to a feeling of confidence and self-respect and not a denial of one’s own subjective reality.

 

I have had the pleasure of meeting other recipients who have taught me through their bravery that stigma can be redefined as the repression of spirituality. God bless you, Andy, because you leave us all asking, "What is stigma?" It doesn’t explain the internal suffering of stigma. In the words of recipient Sally Clay, who was inspiring to me, "I have come to realize that the shame of stigma comes from the repression of the subjective reality within madness that deserves not contempt, nor pity, but respect."

In truly defining stigma, we must recognize this reality and define it as a spiritual one.

 

Part of the process of liberation is freeing our minds, breaking internal and external bonds. Stigma and discrimination prevent us from returning to the community. It becomes the most debilitating handicap and is something that must be changed. DTR is not the panacea or the cure-all. It is not an end; it is a new beginning.

 

To all my brothers and sisters in recovery who have helped me create this manual, by sharing their strength, hope and experience… Thank You.

 

* (Reprinted from OMH News)

 

 

 

 

 

Double Trouble in Recovery (DTR) is a fellowship of men and women who share their experience, strength and hope with each other so that they may solve their common problems and help others to recover from their particular addiction(s) and mental disorders.

 

DTR is designed to meet the needs of the dually-diagnosed and is clearly for those having addictive substance problems as well as having been diagnosed with a psychiatric disorder.

 

We also address the problems and benefits associated with psychiatric medication as well as other issues crucial to mental health; thus we recognize that for many, having addiction and mental disorders represents double trouble in recovery.

 

There are no dues or fees for DTR membership; we are self-supporting through our own contributions.

 

 

Self-help aids the process of recovery in five ways:

     

  1. Self-help provides a social network based on commonly shared experience. Recipients of mental health services are often isolated due to stigma and discrimination within and outside the mental health services system. In this context, socialization becomes an acute problem. When recipients come together in a self-help setting, they share common experiences which lead readily to the formation of social relationships.

  2. Self-help facilitates people’s move from help-recipient to helper. Always being helped makes one feel helpless. It is a demeaning role in our society, leading to low self-esteem and a negative self-concept, in turn increasing the likelihood of more frequent feelings of anxiety. In contrast, the role of helper is highly valued in our society, leading to high self-esteem and to a positive self-concept. This provides a buffer against anxiety and repeated crises.

  3. In self-help groups, people share specific ways of coping based on experience.

  4. Those who cope successfully serve as role-models for individuals with less successful coping strategies.

  5. Self-help provides people some meaningful structure which is not imposed by the outside but rather self-generated by the members themselves.

 

Why might recipients with mental disorders and substance abuse want a separate 12-step program?

  • Traditional 12-step groups are single-focus organizations based on the "one-disease - one-recovery" model. This specialization is largely what bonds members together. However, recovery needs which do not fall within that singular parameter are ignored, misunderstood or stigmatized. Dually-diagnosed clients need and want to address their dual recovery integratively and holistically.

     

  • Dually-diagnosed clients suffer the double stigma of mental disorder and of chemical dependency, with associated social prejudice. These negative attitudes are ubiquitous and are as present the single-focus self-help groups as they are elsewhere in society. These negative attitudes are the antithesis of the mutual acceptance and honesty on which rests the essence of the 12-step recovery program. For the dually-diagnosed, these negative attitudes can be devastating to the dual recovery program.

     

  • Many of the dually-diagnosed are on a prescribed regimen of medication which is as crucial to their total recovery as is abstinence from drugs and alcohol. Traditional 12-step groups often have an unspoken bias against medication. In that context, the dually-diagnosed receive misguided advice which can lead to non-compliance with medication, increased psychiatric symptoms and substance abuse relapse. For the dually-diagnosed, this bias can be devastating to the dual recovery process.

  •  

  • Single-focus 12-step groups cannot offer the dually-diagnosed the honesty, acceptance, emotional support and shared experiences they deserve and need, and which are the most critical elements of the mutual aid process. Where they find these elements, it is often for one aspect of their recovery only: they may not feel comfortable sharing honestly their experiences and cannot relate totally to those who share theirs. They may feel shamed, judged and stigmatized. They may downplay, neglect or hide one side of their recovery needs to other members and to themselves. That is the antithesis of the mutual acceptance and honesty on which rests the essence of the 12-step recovery program. For the dually-diagnosed, this lack of complete mutual acceptance and honesty can be devastating to the dual recovery process.

Thus while there exist many self-help groups, they are single-focus and cannot provide adequate support to individuals dually-diagnosed with a mental disorder and a chemical addiction (alcohol and/or drugs). DTR is intended to overcome the problems encountered by those suffering from both substance abuse and mental disorders. DTR creates a safe environment where clients can discuss the issues of mental disorders, medication side-effects, psychiatric hospitalizations and experiences with the mental health system openly, without shame or stigma.

 

For many persons with dual-diagnoses, DTR is a vital link between being hospitalized and entering society. It provides an ongoing means of support for pursuing recovery, maintaining sobriety and living life in the community.

As one DTR member put it, "for me, coming to DTR was like coming home."

 

 

How does double trouble in recovery work?

 

DTR follows a twelve-step approach to recovery, which has evolved from the original Twelve Steps of Alcoholics Anonymous.

 

In DTR groups, we band together to help ourselves recover from our addictions and mental disorders. We share our experiences to help ourselves become honest, open-minded, and willing. Sharing helps all of us to remember how it was and how we arrived at where we are today. We live one day at a time and practice the Double Trouble in Recovery Twelve Steps.

 

 

What can double trouble in recover do for you?

     

  • DTR can help you realize that you are not alone; that there are others who understand what you have gone through.

  •  

  • DTR can help you believe that you can recover from the dual problems of addiction and mental disorder.

     

  • DTR can give you an opportunity to be helped by helping others who have had similar experiences.

  •  

  • DTR can help you learn how to take responsibility for your recovery.

  •  

  • DTR can help you overcome secrecy and be more comfortable about having a mental disorder and taking prescription medications.

  •  

  • DTR can help you deal with a variety of recovery needs, including mental disorders and forms of substance abuse.

  •  

  • DTR can help you develop a stronger self-esteem and a clearer sense of who you are.

  •  

  • DTR can strengthen your ability to cope with daily life.

  •  

  • DTR can help you challenge stigma and loosen its grip.

  •  

  • DTR can help you make choices and have more control over your life.

What Double Trouble in Recovery does not do.

  • DTR does not provide treatment other than the support mutually shared by its members.

  • DTR does not make diagnoses or dispense medication.

     

  • DTR does not take attendance, keep client records or do case management.

     

  • DTR does not provide advice, advocacy or training.

     

  • DTR does not provide religious guidance other than the spiritual experience members derive from working the program.

     

  • DTR does not affiliate with social agencies or other institutions.

 

How to Start and Run a DOUBLE TROUBLE in RECOVERY Group

 

 

The benefits of self-help rest largely on consumer empowerment.

Thus DTR groups are consumer-run and peer-led. We strongly suggest

that providers do not start or run Double Trouble groups.

 

 

Chairing a Double Trouble Group

 

The following are suggestions to help you get started. Each group takes on its own special identity and no two groups are exactly alike. These suggestions give you a framework to follow.

 

Chairperson

 

It is strongly suggested that the chairperson of the group has been out of the hospital for one year and needs to have had at least one year of freedom from the use of alcohol and/or non-prescription drugs. If there is no such person in your core group, you can count backwards to 11 months, 10 months, etc., and pick as chairperson the individual who has the longest time clean and sober.

The chairperson also needs to demonstrate an ability to:

  • Listen

  • Be accepting and tolerant of others

  • Understand his or her own alcohol and/or drug addiction

  • Understand his or her own mental disorder

  • Run a Twelve Step meeting (or be willing and able to learn how)

Chairperson's Role

The chairperson’s role is to provide direction and mutual support, to focus for the group, to keep things running smoothly and to provide an atmosphere of recovery, so that our personal recovery comes first.

"For our group purpose, there is but one ultimate authority, a loving God, as He may express Himself in our group conscience. Our leaders are but trusted servants, they do not govern."**

 

Rotating Chairmanship

 

The group will need to come up with its own policy about rotating the chairperson. As a suggestion, a chairperson should be out of the hospital for at least a year and to have one year clean and sober. But this is not written in stone and if you have to, count backwards (11 months, 10 months, 9 months, etc.) and pick the person who has the longest time clean and sober.

 

_________________________

 

 

Let’s not louse it all up with indulging in people’s complexes and things that are interesting to the mental health mind and have little to do with our actual DTR work. For if we ought to look at our program, when simmered down to the last, it resolves itself to the words Love and Service. Let us as chairpersons remember to use our direction with kindness, consideration and tolerance. And remember, none of us would be here today if somebody hadn’t taken the time to explain this to us, to give us a little pat on the back, to take us to a meeting or two, to do innumerable little kind and thoughtful acts on our behalf.

 

We are living proof that DTR works as long as we work the program. We owe it to the newcomer to be there. Remember "faith without work is dead." And always remember, our fellowship is founded upon equality; even though you sit in front of the room, it is still one dually-diagnosed person helping another. We are fellows in our program, we don’t play politics, we don’t listen to gossip and we always give the next guy the benefit of the doubt. Be quick to praise and slow to condemn, and if the speaker doesn’t say exactly what you think he ought to say, don’t criticize, he may be saying exactly what the guy in the last row wants to hear.

 

Another thing that is difficult, and probably none of us do it well yet, is a matter of tolerance, for ourselves as well as for others. We are inclined to have closed minds, and that’s the reason why we find our spiritual teaching difficult. From our group experience, we have learned kindness and consideration for the man or woman who is just beginning to walk along a spiritual path.

 

 

Sharing Responsibilities

 

If possible, try not to run the group alone. Starting a group may be stressful and demanding at times, and no one should attempt such a project at the expense of one’s self or well-being. By sharing responsibilities and tasks with others, you can prevent burnout. Seek out two or three others who are interested in starting a group. This core group can work together in getting the DTR group off the ground.

The group has one primary purpose, to carry its message to the dually-diagnosed person who still suffers. Membership is the desire to stop drinking and drugging and to take care of one’s mental health.

 

_________________________

 

 

Getting In Touch With

 

If you and a few others (we suggest no less than 2 or 3 people to start a group) think you may want to start a Double Trouble group, the first thing you need to do is to find out more about Double Trouble:

Experience Double Trouble: Attend as many different existing groups as you can and attend each more than once. Get involved with the group. This way, you will gain a sense of what it is like to be an active participant in the fellowship of Double Trouble; you can not only find out if it is for you, but also what is involved in running the group, what to expect.

Contact us by mail, telephone or fax. If feasible, we will give a presentation about Double Trouble, including the history and goals of the fellowship, as well as run a mock group so that you can experience Double Trouble first hand. Alternatively or in addition, we will be glad to send you a package of materials about Double Trouble including how to start and run a group; we can also provide your group with information pamphlets for consumers and for providers, as well as Double Trouble coins and posters.

 

In sum, before taking any other steps toward starting a group, experience the Double Trouble fellowship and inform yourself as much as you can.

 


 

 

Finding a Meeting Place

 

It is a good idea to maintain positive working relationships with organizations in the community, since you may want to ask them for the use of their space to hold your regular meetings.

The types of organizations that frequently allow self-help groups to meet in their spaces are:

    • churches/synagogues

    • community-based organizations

    • schools

    • libraries

    • psychiatric hospitals

    • community recreation centers

    • local mental health associations

    • local community mental health centers

    • local clubhouses run by consumers

    • even someone’s home if no other space is initially available.

When you meet in one of these settings, please keep the group anonymous and confidential.

 

You will want to work out agreeable terms for the use of space, such as length of time the space is available each week and cost. (Sometimes the host organization asks for a modest donation for the use of the space and group members chip in what they can to defray the cost; donations from group members should be voluntary.)

 

Be sure to clarify in advance who is responsible for letting people into the building before the meeting and who is responsible for unlocking and locking the doors, if you meet after business hours.

 


 

 

Meeting Environment

 

The place where the group meets should be safe, properly lit and heated, provide enough seating and adequate space, and afford a fair level of privacy.

 

The space should be free of noise and other distractions such as phones ringing.

 

It is important that group leaders prepare the space before the meeting starts.

 


 

 

 

Relationship with Providers

Consistent with the basic principles and benefits of self-help groups, it is strongly suggested that providers do not start or run DTR groups. However, providers are encouraged to and can work in partnership with consumers to support the recovery process. To that end, providers can:

       

    • Find out more about DTR, learn about how self-help complements formal treatment, provides a bridge for the aftercare transition and a stable source of support for clients in their life-long struggle to recover.

    • Refer clients to DTR meetings

    • Encourage regular attendance

    • Support clients’ initiatives and efforts to start a DTR group meeting at their facility or in the community

In addition and in the spirit of partnership toward recovery, it is suggested that providers:

       

    • Understand consumers’ efforts to develop their own way of relating their experience

    • Find out about and respect consumers’ values, perspectives, needs and goals

    • Understand consumers’ ability to recognize what works and what doesn’t

 

 


 

 

 

Publicizing the Group

 

Let health care providers know about the existence of the group. Provide them with the day, time, location and other essential information about the group meeting.

 

If possible, have a flyer made up announcing the group. Sometimes an organization will agree to make up a simple flyer and provide you with free photocopies. Good places to post flyers include churches and synagogues, community-based organizations, schools, libraries, community recreation centers, local community mental health centers and psychosocial clubs.

 

You might want to consider using the Double Trouble brochure as your publicity tool and add the day, time and location of your meeting to it.

There also might be an opportunity to place an announcement in a local newspaper. Keep your announcement simple and in the spirit of anonymity use the group’s name only, not any single individual’s name.

 

Sample copies of a publicity flyer, a news release and the DTR brochure follow this section. They can be used as master copies for making photocopies. Be sure to ask permission before hanging up flyers.

 

 

Don’t Reinvent the Wheel

 

If at all possible, contact an existing DTR group for help in getting started. Go to and participate in an established meeting. Invite the group chairperson to come and help the group get started and run.

 


 

 

 

Some Traps to Avoid

 

Avoid expecting too much too soon. It takes time to get a group going and for the members to feel comfortable and willing to participate.

 

Meetings may be disorganized at first, but don’t give up. One group leader was the only person at his meeting most of the time for many months. He went faithfully and, if no one showed up, he would read recovery books alone for the time allotted for the meeting. After nearly a year, others joined him. As a result, there is now a thriving, caring group in that community.

 

Only do what is necessary and don’t promise more than you can deliver. Everything does not have to happen at once. Allow time for things to evolve.

 

From time to time, people may slip from sobriety or not take care of their mental health. This is to be accepted. Be patient with one another and do not judge.

 

The group will develop in response to its members’ needs and will take on a special flavor all its own -- a group conscience. Pay attention to the special nature of the group and do not try to force it in one direction or another.

 

 

 

Additional Considerations When Starting a Double Trouble Group


Keep it Simple

 

Let your primary purpose be to carry out DTR’s message of hope, acceptance and experience.

 

Be Open-minded

 

In the DTR fellowship, we band together for common good and recovery. With open-minded understanding for each other, we honestly expose our problems and our weaknesses; we also acknowledge our strengths. While we each experience our own suffering, problems and weaknesses in different ways, we focus and build on our shared experiences to gain and embrace our fellow DTR members for who and what they are. We are individuals, not labels or diagnoses, and we treat others as each of us wants to be treated.

 

Don't Give Advice About Prescribed Psychiatric Medications

 

Never suggest that a person stop taking medications prescribed by his/her physician. This could be dangerous. Refer the person back to his/her physician for help.

 

Looking for Support with Mental Health and Substance Abuse?

 

Double Trouble in Recovery gives people an opportunity to get together and support one another in recovery.

 

 

MARK YOUR CALENDAR

MEETING:

TIME:

PLACE:

 

For Group Information, Call:

 

Membership is open to anyone who is currently experiencing or has formerly experienced dealing with mental disorders and chemical addiction.

 

DOUBLE TROUBLE IN RECOVERY NEWS RELEASE

 

FOR IMMEDIATE RELEASE

FOR MORE INFORMATION, CONTACT:

________________________

(Name)

DT

(Address)

 

 

 

City) (State) (Zip)

 

hone Number)

 

 

The Double Trouble in Recovery Group

will meet __________________________ at  _____________________________

(Weekly or Monthly)

at  ______________________________________

(Place)_______________________________________

(Address)

 

Double Trouble in Recovery gives people an opportunity to get together and support one another in recovery. Membership is open to anyone who is currently experiencing or has formerly experienced dealing with a mental disorders and chemical addiction.

 

 

DOUBLE TROUBLE in RECOVERY

 

Meeting Format

 

DTR Meeting Format:

 

DTR meetings follow a traditional twelve-step format.  An outline of a meeting format is provided below.

 

Welcoming

 

Before the meeting starts, it is important for the group chairperson and co-chairs to welcome people as they come in. This helps create a climate of warmth and hospitality.

 

Introduction by Chairperson

 

The group chairperson introduces himself or herself by first name only and welcomes everyone to the meeting. The chairperson also identifies himself or herself as having a dual-diagnosis. At this point, it is especially important to welcome back those who have been absent or coming back after being in the hospital or after a slip or relapse. They need to be greeted with acceptance and never judged.

 

Moment of Silence

 

The chairperson invites everyone to observe a moment of silent reflection for members who are absent, hospitalized or still suffering with addictions and mental disorders. The group is then invited to recite the Serenity Prayer.

 

Reading of DTR Mission Statement

 

The chairperson asks various members to read different parts of the DTR mission as follows:

     

  1. DTR Preamble
    DTR How It Works / Twelve Steps of DTR

  2. The Promises

  3. On Recovery

Group Member Introductions

 

Next, group members have an opportunity to introduce themselves, using their first names only, and to identify themselves as having a dual-diagnosis. This step gives everyone a chance to be welcomed by the group and to feel accepted. Group members greet each one with a simple "Hi" or "Welcome."

 

 

Length of Meeting

 

Most groups meet for an hour to an hour and a half.

 

 

Group Business

  • Announce the location of refreshments, rest rooms, etc.

  • Ask others for their announcements.

  • Take care of other group business as needed.

 

Group Guidelines

 

Members are reminded of the group guidelines or norms for behavior. These include the following:

  1. Ask members not to bring alcohol, non-prescription drugs, drug paraphernalia or weapons to meetings. This is to protect the group, the meeting place and DTR as a whole.

  2. Ask members who may have taken alcohol or non-prescription drugs in the last 24 hours to refrain from sharing during the second part of the meeting. This is to ensure that we hear from you and not the drugs. Suggest that they speak to the group chairperson, to the speaker or to anyone else in the room with whom they are comfortable, at the end of the meeting.

  3. Remind the members that this is an anonymous program, which means that what takes place during the meeting stays in the room when the meeting ends. All who were at the meeting and what they said or did remains confidential. This protects everyone and helps engender a feeling of trust and comfort in the group.

  4. Ask members to limit their comments during the sharing time to five minutes to ensure that all have a chance to share and that the meeting ends on time.

  5. Recall for the group that after a member shares his or her feelings there is no cross-talk or lecturing of the person who has spoken. Encourage members to express their own experience and feelings in response to others.

  6. State that sharing is voluntary.

  7. If the group needs to take up a collection to pay small expenses associated with running the group, remind the group that you traditionally pass a basket to remain self-supporting.

 

Speaker

 

Allow 15 - 20 minutes for a speaker to share his or her experience dealing with dual-diagnosis.

 

Sharing

 

(if time permits)

Invite group members to share briefly their experience in response to the speaker (5 minutes maximum). This needs to be voluntary and some people may choose to "pass."

 

Closing

 

Invite group members to recite together the Serenity Prayer as a closing. You can include here again a moment of silence for those still struggling with addiction and mental disorders, and still on the street.

Following is a scripted format for use in conducting a DTR meeting.

Also included here are copies of the Serenity Prayer, the DTR Preamble, How it Works, the Twelve Steps of DTR, The Promises and On Recovery. These pages can be used as master copies for making photocopies.


Chairperson Format

 

     

  1. Hi, my name is (chairperson’s name) and I am dually-diagnosed. I’d like to welcome everyone to this meeting of Double Trouble in Recovery. We meet here every (day and time).

  2. Please help me open this meeting with a moment of silence for those still sick and suffering dually-diagnosed persons in and out of the room, followed by the Serenity Prayer for those who care to join me (Serenity Prayer).

  3. I’ve asked (first name) _______________ to read the "Preamble."I’ve asked _______________ to read "How it Works" and "The Twelve Steps of DTR."

    I’ve asked ________________ to read "The Promises"

    I’ve asked ________________ to read "On Recovery"

    I’d like to thank my readers.

     

  4. I’d like to extend a warm welcome to any newcomers and anyone who’s just coming back. Just sit back, relax and listen.

  5. Is this anyone’s first meeting, or are there any newcomers?

  6. Would anyone like to introduce themselves (stating addiction and/or dual-diagnosis is optional)?

  7. This is an anonymous program, which means that who you see here and what you hear here stays here in this room. This is so we all feel comfortable with what we say.

  8. When the speaker speaks, we suggest that you do not compare stories, but identify with the feelings. We all took different routes to get here, but the feelings are the same. The speaker ____________________ is here to share his/her experience, strength and hope.

    (SPEAKER)

     

  9. We will now open the meeting for sharing. We ask that you limit your sharing to 5 minutes to give everyone who wishes a chance to speak.

    (SHARING)

  10. Anonymity is the spiritual foundation of all traditions, ever reminding us to put principles before personalities… which means who you see, what you hear, please leave it here when you leave.

  11. We have a nice way of closing (moment of silence). Please join together in reciting the Serenity Prayer.

 

Serenity Prayer

 

God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

 

Preamble

Double Trouble is a fellowship of men and women who share their experience, strength and hope with each other so that they may solve their common problems and help others to recover their particular addiction(s) and mental disorders.

 

DTR is designed to meet the needs of the dually-diagnosed and is clearly for those having addictive substance problems as well as having been diagnosed with a mental disorders.

 

We also address the problems and benefits associated with psychiatric medication as well as other issues crucial to mental health; thus, we recognize that for many, having addiction and mental disorders represents Double Trouble in Recovery.

 

There are no dues or fees for DTR membership; we are self supporting through our own contributions.

 

DTR is not affiliated with any sect, denomination, political group, organization or institution.

 

Our primary purpose is to maintain freedom from our addiction(s) and to maintain our well-being.

 

 

How It Works

 

We band together to help ourselves recover from our addictions and mental disorders. We share our experiences in order to help ourselves to become honest, open-minded and willing. Sharing helps all of us to remember how it was and how we arrived at where we are today.

We live one day at a time and practice the following Double Trouble Twelve Steps.

 

 

     

  1. We admitted we were powerless over our mental disorders and substance abuse -- 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 whenever 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 other dually-diagnosed people and to practice these principles in all our affairs.

 

The Promises

 

If we are painstaking about this phase of our development, we will be amazed before we are halfway through. We are going to know a new freedom and a new happiness. We will not regret the past or wish to shut the door on it.

 

We will comprehend the word serenity and we will know peace. No matter how far down the scale we have gone, we will see how our experiences can benefit others. The feeling of uselessness and self-pity will disappear.

We will gain interest in our fellows. Self-seeking will slip away. Our whole attitude and outlook on life will change. Fear of people and of economic insecurity will leave us. We will intuitively know how to handle situations which used to baffle us. We shall suddenly realize that our Higher Power is doing for us what we could not do for ourselves.


 

Adapted from the A.A. Big Book, pp. 83-84.