Many Pagans seem to prefer a mutually supportive, spiritually based twelve step approach to recovery  over non-spiritually based programs such as Secular Organizations for Sobriety, where one is expected to keep his or her spiritual beliefs separate from recovery, or Rational Recovery, which is not spiritually based and does not encourage members to seek support from others in recovery.
Generally speaking, Pagan twelve step meetings follow the same format as other twelve step meetings except that they use Pagan friendly readings (which have not been approved by the General Service Office of Alcoholics Anonymous or other twelve step organizations), and substitute Pagan friendly prayers for the Lord’s Prayer and the Serenity Prayer For example, the Recovery Spiral: A Pagan Path to Healing by Cynthia Jane Collins is sometimes used instead of or along with the Big Book of Alcoholics Anonymous, and the Native American Great Spirit prayer may be substituted for the Lord’s Prayer Some Pagan twelve step groups have reworked or reworded the twelve steps so as to make them more applicable to Pagans, especially in allowing for a Polytheistic and non-gendered view of divinity. The members of Pagan twelve step groups are still expected to work the twelve steps as a means of spiritual growth, obtain a sponsor, make amends for harm they have caused, and to help others.
Some twelve step meetings for Pagans are eclectic, meaning that anyone from a twelve step recovery program, regardless of the nature of their addiction, may participate in the meeting. This is in sharp contrast to Alcoholics Anonymous’ concept of “Singleness of Purpose” which holds that alcoholics should only work with other alcoholics.