Ted Gradman

Dr. Ted Gradman (UCLA, Ph.D., 1989, Stanford fellowship 1989-91) is a Founding Fellow of the Academy of Cognitive and Behavioral Therapies (1999 to present). He combines empirically supported CBT interventions with neuroscience. This Neuro-CBT uses CBT tools to shift clients out of alarm modes into more adaptive functioning in anxiety conditions, PTSD, depression, bipolar, couples, and interpersonal issues as well as testing and therapy for brain injury, memory changes, stroke, ASD, and ADHD. His practice, located in San Mateo, CA,  serves ages 7 to 90+ and provides in-person and telehealth services.

Click here to learn more about Dr. Gradman’s work and approach.

How did you become interested in psychology in the first place?

I started volunteer work with older adults as a high school student to better understand the needs of my grandmother (who lived with us). This sparked an interest in psychology and science. At Oberlin College, I pursued a variety of science and liberal arts classes (English major) and volunteered in and later coordinated a practicum class in Institutional Gerontology.

What is your educational and work history?

After college, I continued volunteering with seniors and also assisted in research projects in Berkeley. I trained at UCLA from 1984 to 1989, followed by two years at the Stanford Older Adult Center in gerontology, CBT and neuropsychology. Next, I worked as a neuropsychologist at the Mills-Peninsula Hospital Multidisciplinary Neurological Rehabilitation Program (1991-1997) in San Mateo (between San Francisco and Palo Alto), providing further experience in neuropsychological assessment and CBT.

Through many years of seminars through ABCT, the Northern California CBT Network, the Gottman Institute, the Northern California Neuropsychology Forum and UCSF Memory and Aging Center Grand Rounds, I keep learning more about CBT and neuroscience as well as cultural, gender, and LGBT issues. At UCLA I received two years of specialized training at the Human Sexuality Program. My published works include a journal article on complex cognitive functioning with treatment for Type II diabetes (1993), a chapter on male sex roles and retirement (1994) and a chapter on personality disorders and treatment outcome in older adults (1999). I’m now writing a book integrating CBT tools with basic brain information: Bike Brain: Getting a Handle.

Initially my practice focused on adults and older adults and then expanded to younger clients and couples after more training. I’m now working with many complex cases in conjunction with physicians and other health care professionals in the San Mateo area.

What are your personal strengths as a practitioner?

My practice focuses on combining neuroscience with cognitive-behavioral therapy, or Neuro-CBT for short. This combines straightforward information about the brain with CBT.  The back and front wheels of a bicycle, power and steering functions, are presented in a model that shows the brain’s alarm and adapt processes. For simplicity, these are also referred to as the lizard and wizard. This model is used to reduce shame and blame, aim for some humor and enable briefer treatment.

In most cases, treatment takes place in three steps. After discussing the individual’s situation, assessment results and therapy questions, we first work on how the brain gets stuck in the alarm mode. This was inspired by research from UCLA focused on OCD and brain circuitry and is applicable to other types of anxiety as well as PTSD, depression, and interpersonal issues.

The second step involves cognitive tools.  I use existing tools and enjoy modifying and inventing new tools to adapt to individual needs. Using structured tools in a collaborative fashion enables rapid learning. These include a worry (or annoyance or other adverse experience) log to contain worry or annoyance and a thought record to train the adapt circuitry to mollify the alarm circuitry.

The third step involves behavioral tools to approach and master situations that clients are avoiding, often in subtle ways. This starts with approaching some discomfort with sensations briefly. In OCD as well as other anxiety issues, we also approach ways to refrain from compulsive behaviors, starting small. We also approach the internal thinking patterns by listening to overstated stories to nurture humor (exposure response prevention). Social anxiety involves light-hearted experiments starting with “eye, smile & hello practice.” All of these are done jointly, in-session to start.

The client practices these “exercises” in their “brain gym” for several weeks—“home-play.” I like to use sports analogies in the process (biking, surfing, martial arts, debating or whatever the client likes). Clients are also encouraged to exercise physically (there’s an easy-to-use core strength machine in the waiting room). We also talk about a “social gym” to practice social tools. This approach appears to appeal to both men and women, encouraging men to join in with women rather than avoid therapy with the tools, sports mindset and science-based information.

I emphasize brief treatment to reduce suffering as quickly as possible and to make therapy more accessible. Research findings are sometimes included in discussion to provide clients with scientific information. I enjoy collaborating with physicians (especially for illness and pain anxiety) and family members (to enable follow-through, hear different perceptions, and aim toward family unity). My goal is also to make therapy enjoyable and encouraging.

How do you remind your clients of their strengths during the therapy process?

This is a primary goal and a complement to empathic listening. I give frequent positive reinforcement to clients’ insights and actions when having a discussion or working on a tool. I use tools like the Positive Data Log to document positive information about their experiences or other positive evidence. I weave the client’s actions and insight into my thinking. I teach people to provide frequent self-validation of vulnerable feelings and their own daily thumbs-up as well.

Are you involved in other types of professional activities in addition to your private practice?

Yes, I coordinate a local CBT consultation group (20+ years) to discuss research, cases, and practice issues. I give talks in both neuropsychology (Use It or Lose It) and Neuro-CBT at Mills-Peninsula Hospital and other organizations like the Rotary Club. I have participated for many years in Mills-Peninsula Hospital Psychiatry Department meetings and utilization review committee. I’ve been affiliated with Mills-Peninsula Hospital as a provider for over 30 years.

Who are your mentors?

I’ve had many great teachers. Connie Hammen, Wilfred van Gorp and many others at UCLA, and the West LA VA started me off with academic knowledge and clinical guidance.

Larry Thompson and Dolores Gallagher-Thompson enhanced my CBT and neuropsychological skills at the Stanford Older Adult Center.

Chris Padesky and Kathleen Mooney introduced me to great hands-on tools at Camp Cognitive Therapy (attended 7 years) and Jackie Persons, Michael Tompkins and the Northern California CBT Network have continued in that tradition.

David Burns, Matt May, and others deepened my CBT knowledge with their great consultation groups.

The Northern California Neuropsychology Forum and UCSF Memory and Aging Center Grand Rounds keep my knowledge of neuroscience developing. John and Julie Gottman taught me a wide range of couples tools and science.

My wife, Hilary Perr, a retired UCSF pediatric GI specialist, keeps me up-to-date on many science topics and keeps the humor rolling. I’ve read many treatment manuals and research articles.

Michelle Craske and David Barlow have been very helpful in working with panic disorder and other forms of anxiety (I’m now using a 3-session model for panic based on their model).

David Clark’s social anxiety work has helped me achieve faster results.

Steven Hayes, Marsha Linehan, and Susan Johnson have been influential through years of classes and reading in ACT, DBT and EFT.

When not practicing CBT, what do you do for fun?

​I love to ice skate. April 2025 marks my 30^th year of participation in the US Adult National Figure Skating Championships. For 2024 and 2025, I’m skating to music from the movie Amelie for the technical program with jumps, spins, and fancy footwork. I’m also skating to “There’s No Sunshine When She’s Gone” and “Let the Sunshine In” (in hippie garb) for the interpretive program (as featured in the April 2024 Oberlin Alumni Magazine, click here for a 2016 performance). I enjoy helping athletes and performers handle the stresses of the spotlight or exam with CBT tools.

How long have you been a member of CBT organizations?

Since 1999, as a founding fellow with the Academy of Cognitive and Behavioral Therapies (ACBT). I joined ABCT in 2013. ABCT has been instrumental in providing a wide outlet of resources to keep up with the field and many opportunities to network with like-minded colleagues.