This study examines the prevalence of endorsing the twelve step approach and the use of prayer, meditation, and holistic techniques in a national sample of 139 substance abuse treatment centers. Ninety one percent of the programs endorsed a twelve step orientation. Twenty six percent of the programs actively used prayer and 58% used meditation as a component of treatment. Thirty three percent of the programs used some form of a self-designated holistic technique. There was a divergent range of techniques that were used by programs, falling into four broad categories: (1) nutrition, exercise, relaxation and physical health; (2) recreation and adventure-based activities; (3) religious and spiritual practices; and (4) the use of specific therapy modalities.