An operant approach to the treatment of writer's cramp

A theoretical model of writer's cramp is presented. In addition to the original emotional arousal and subsequent conditioned stimuli inherent in a classical conditioning paradigm, this model stresses the role of operant behaviors in the maintenance of the disorder. The immediate consequences of the actual cramp and subsequent escape behaviors are emphasized. An extinction procedure consisting of response-cost and response-prevention measures is tested using an A-B-A-B design. Two patients totally unable to write, were able to increase cramp latency and were gradually retrained to write. Follow-up assessments at 6, 9 and 12 months confirmed the treatment gains.