Evaluation

• Limitation: ethical issues

  Token economy systems are controversial because severely ill patients cannot get privileges because they are less able to comply with desirable behaviours than moderately ill patients- so severely ill patients suffer discrimination. Also, CBT may challenge a person's paranoia- but might interfere with their freedom of thought? If, for example, CBT challenged a patient's belief in a controlling government, that could stray into modifying their politics. Ethical issues like these make psychological therapies for schizophrenia controversial
• Limitation: may help but don't cure

  CBT helps patients make sense of their symptoms. Family therapy reduces the stress of living with schizophrenia. Token economies help to make patients' behaviour more socially acceptable. These things are all worth doing, but should not be confused with curing schizophrenia. Biological therapies do not cure schizophrenia ether but they do reduce the severity of the symptoms and thus may be more desirable
• Limitation: quality of some evidence

  Small-scale studies that compare patients before and after psychological therapies have found positive results. But these studies often lack a control group or lack random allocation to conditions- but they are included interviews. This may mean that the effectiveness of psychological therapies is overestimated by the evidence
• Limitation: alternative psychological therapies are under-researched

  For example, NICE recommends art therapy, if a qualified art therapist is available who has experience working with schizophrenia patients. However, these therapies are not well researched so it is unclear how effective they are. This questions whether under-researched therapies should be made available to patients