For flat chested sex doll users who have already exhibited risky behaviors, treatment is more effective than punishment. The "Cognitive Restructuring Therapy" program promoted in Washington State helps participants distinguish between fantasy and reality and establish healthy ways of expressing emotions. Two-year follow-up data from this program showed that the recidivism rate among participants who completed treatment was 11%, while the recidivism rate for those who did not participate reached 34%. The focus of treatment is on addressing deep psychological needs, rather than simply prohibiting behavioral expression.