{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T16:23:14Z","timestamp":1762273394244,"version":"3.41.2"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Developed over nine decades ago, the 12 Steps were intended to provide structured and clear guidelines to promote recovery from alcohol use. The steps are designed to help individuals find a sense of purpose, meaning, and hope. The 12 Steps are meant to be guides for an ongoing process or spiritual progress. A more concrete way of understanding the steps relative to spiritual principles may be instructive for those working the steps and seeking a fulfilling meaning and purpose for their lives.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>This paper provides a framework for understanding the 12 Steps in accord with four principles of spirituality: awareness, acceptance, interdependence, and self-transcendence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methodology<\/jats:title>\n                  <jats:p>A matrix was developed using each of the four principles of spiritualty. Each word or phrase from each of the 12 Steps was assigned to one principle. Examples for key words or phrases were provided.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Each of the 12 Steps are mapped to the four principles of spirituality, with annotations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The resulting guide serves as a concrete and instructive guide to understanding the spiritual nature of the 12 Steps.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/alcalc\/agaf023","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T06:07:22Z","timestamp":1747202842000},"source":"Crossref","is-referenced-by-count":1,"title":["Four pillars of spirituality: an interpretive guide for the 12 Steps of Alcoholics Anonymous"],"prefix":"10.1093","volume":"60","author":[{"given":"Deborah S","family":"Finnell","sequence":"first","affiliation":[{"name":"Change Management Alternatives , Buffalo, NY 14209,","place":["United States"]},{"name":"Johns Hopkins School of Nursing , Baltimore, MD; University at Buffalo School of Nursing, Buffalo, NY,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy J","family":"Finnell","sequence":"additional","affiliation":[{"name":"Change Management Alternatives , Buffalo, NY 14209,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"volume-title":"A Fragment of History by Bill","year":"1953","author":"Alcoholics Anonymous","key":"2025061007015934600_ref1"},{"volume-title":"Alcoholics Anonymous","year":"1976","author":"Alcoholics Anonymous","key":"2025061007015934600_ref2"},{"volume-title":"Twelve Steps and Twelve Traditions","year":"1988","author":"Alcoholics Anonymous","key":"2025061007015934600_ref3"},{"volume-title":"PsychCentral Newsletter","year":"2013","author":"Brennan","key":"2025061007015934600_ref4"},{"key":"2025061007015934600_ref5","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1093\/alcalc\/agy089","article-title":"Systematic reviews of mindfulness and acceptance and commitment therapy for alcohol use disorder: should we be using third wave therapies?","volume":"54","author":"Byrne","year":"2019","journal-title":"Alcohol Alcohol"},{"key":"2025061007015934600_ref6","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1177\/1052562921990065","article-title":"Defining self-awareness in the context of adult development: a systematic literature review","volume":"46","author":"Carden","year":"2022","journal-title":"J Manag Educ"},{"key":"2025061007015934600_ref7","first-page":"46","article-title":"Spiritual themes in clinical pastoral education","volume":"18","author":"Fowler","year":"1997","journal-title":"Journal of Supervision and Training in Ministry"},{"volume-title":"Man\u2019s Search for Meaning","year":"1963","author":"Frankl","key":"2025061007015934600_ref8"},{"key":"2025061007015934600_ref9","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1080\/10826084.2019.1681450","article-title":"A critical review of qualitative interview studies with alcoholics anonymous members","volume":"55","author":"Glassman","year":"2020","journal-title":"Subst Use Misuse"},{"volume-title":"The Art of Living","year":"2017","author":"Hanh","key":"2025061007015934600_ref10"},{"key":"2025061007015934600_ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.brat.2005.06.006","article-title":"Acceptance and commitment therapy: model, processes, and outcomes","volume":"44","author":"Hayes","year":"2006","journal-title":"Behav Res Ther"},{"key":"2025061007015934600_ref12","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1176\/ps.48.11.1445","article-title":"Clinicians\u2019 referral and matching of substance abuse patients to self-help groups after treatment","volume":"48","author":"Humphreys","year":"1997","journal-title":"Psychiatr Serv"},{"volume":"215","doi-asserted-by":"publisher","journal-title":"Drug Alcohol Depend","key":"2025061007015934600_ref1h","DOI":"10.1016\/j.drugalcdep.2020.108213"},{"key":"2025061007015934600_ref13","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1093\/clipsy.bpg016","article-title":"Mindfulness-based interventions in context: past, present, and future","volume":"10","author":"Kabat-Zinn","year":"2003","journal-title":"Clin Psychol Sci Pract"},{"key":"2025061007015934600_ref14","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1111\/add.13590","article-title":"Is Alcoholics Anonymous religious, spiritual, neither? 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