Talk therapies have limited usefulness

Talking therapies and counseling have little to offer in the way of "cure" for patients who suffer from major cognitive disorganization now characterized as psychosis, delusions, paranoia, schizophrenia, bipolar disorder, obsessive-compulsive disorder, borderline personality, or violent sociopathic behavior.

This reality has been known since double-blind trials of psychotherapy protocols in the 1950s.  Thus existing medications—with all of their real faults and dangers—may have an ongoing role in the management of severe mental dysfunction.  The challenge is to determine in which patients they can be used safely and for how long.
 
This being said, there may be ancillary  roles for some forms of talk therapy in the long term management of delusions or hallucinations.  Community and individual therapy has been used in helping some clients to recognize when "their" voices are urging them to do things that may harm themselves or others.  The record seems somewhat less clear with regard to paranoid delusions and fearfulness.
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