One major issue with CBT is the lack of availability. Despite it being recommended in the NICE study, it estimated that as little as 1 in 10 actually get access to this form of therapy.
CBT is not suitable for all patients.
People with extreme agitation will not be able to rationalize their thoughts in the way that CBT demands. It requires a level of insight and awareness into one's own thinking process, which not everyone has the ability to do.