Editing Paradoxical intention (section)

== Criticisms ==

=== Relative effectiveness ===
The effectiveness of paradoxical intention as a substantial treatment for insomnia has been challenged. In fact, research indicates that stimulus control therapies and sleep restriction therapies have been proven to be more effective in treating insomnia.<ref>Principles and Practice of Sleep Medicine. (2005). American Journal of Clinical Dermatology, 6(6), 415.</ref>

The current understanding of paradoxical intention with regards to sleep states that it alleviates the patient's “effort associated with sleep”. Espie and Lindsay argue that instead of eradicating the anxiety, it may simply be redirected towards the “effort to stay awake”.<ref name=":4" /> Espie says that since the objective of sleep therapy is to view sleep as an involuntary physiological process that occurs passively, trying to put it under voluntary control by instructing patients to deliberately stay awake could be counterintuitive.<ref>Colin A. Espie, in Behavioral Treatments for Sleep Disorders, 2011</ref><ref name=":4" />

=== Lack of reliable and objective research ===
Turner and Ascher say that paradoxical intention has not gained complete acceptance in behaviour therapy because the research supporting its clinical efficacy is mainly limited to uncontrolled case studies.<ref name=":3" />

Some have argued that studies have also shown a lack of evidence directly gleaned from the clients in order to explain the effectiveness of PI approaches, rendering the data unreliable, and that the insomniac self-reports are unreliable as participants may provide socially desirable answers.<ref>{{Cite journal|last=Riebel|first=Linda|date=1984|title=Paradoxical intention strategies: A review of rationales.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/h0085982|journal=Psychotherapy: Theory, Research, Practice, Training|language=en|volume=21|issue=2|pages=260–272|doi=10.1037/h0085982|issn=1939-1536}}</ref><ref>Carskadon, M. A., Dement, W. C., Mitler, M. M., Guilleminault, C., Zarcone, V. P., & Spiegel, R. (1976). Self-reports versus sleep laboratory findings in 122 drug-free subjects with complaints of chronic insomnia. ''Am J Psychiatry'', ''133''(12), 1382-1388.</ref>

Thereby, paradoxical intention is viewed as a last case resort in the event of the ineffectiveness of other relaxation-desensitisation programs.<ref name=":1" /><ref name=":0" />