Leon C Pereira PhD : Clinical Psychologist : Kaneohe, HI

About Me

I am a licensed Clinical Psychologist, in private practice, in Kaneohe, Hawaii. I help children (age 4 & up), teens, and adults, providing individual, family, and couples counseling. My specialty is treating emotional problems (stress, depression, anxiety, anger, etc), correcting behavior problems (including ADHD), improving parenting, and counseling couples.

Utilizing an individualized, collaborative, problem-solving approach, I provide Cognitive-Behavior Therapy tailored to your needs. Together, we resolve issues from the past; change present thoughts, feelings, and behaviors; and, work toward your goals. Please use the menu, on the right, to learn more about my approach.

I graduated from the University of Hawaii, at Manoa, with a dual Doctorate degree in Clinical Psychology and Behavioral Psychology. I also have a Master"s Degree in Social Psychology from the University of Bombay, India. I have been in private practice from February 1998 and have additional experience as a Therapist or Psychologist since 1987.

I have taught, conducted research, and published in the field of Clinical Psychology. My Master"s thesis investigated the relationship between Self-Concept and Social Behavior; my Doctoral dissertation was a pioneering study of the relationship between Personality Subtypes and Depression. As an Adjunct Professor at Hawaii Pacific Unversity, I have taught online and on-campus undergraduate psychology courses.

Please call to schedule an appointment or if you have any questions. My office is within easy access of Honolulu, Aiea, Kailua, Kaneohe, and adjoining areas.

Anger Management

About My Book

Anger is an unpleasant emotion that many of us feel and often express aggressively. How often a person feels angry, express it intensely, and stay angry varies. Anyone who gets angry frequently, intensely, or for a significant duration can benefit from Anger Management.

This guide provides the information and insight that you need to understand why you get angry and the effects that anger has on you and others. It provides advice for changing your mindset and strategies to employ to minimize the chances of getting angry and for handling problem situations without aggression.

This is a concise manual for anger management and problem-solving. In it, I present the information, insights, and recommendations with which I have guided clients, in my private practice, and which they have effectively employed. It does not simply tell you how to reduce or eliminate your anger, it also teaches you how to more appropriately handle problem-situations. It is a practical guide and does not contain pages and pages of definitions, research, anecdotes, etc. I get straight to the point of helping you.

First, I briefly describe what anger is, explain what happens when you get angry, and the effects that anger has on you and others. I then explain how to make long-lasting changes-how to minimize the chances of getting angry and how to address anger-triggering situations. I teach you a mindset, specific strategies to employ, and actions to take when you get irritated by, or upset about, something.

I also provide tips for calming yourself, learning to be assertive, and for parenting more effectively.


My Practice

What form does psychotherapy take in my practice?

For children, therapy will involve cognitive-behavioral, play and art therapy with the child. I also work with the parent or parents to improve their understanding of the principles of good parenting, to relieve stress, and to improve their relationship with, and behavior management of, their child. Other family members are actively involved in therapy, when appropriate.

For adolescents, a similar approach is employed. However, as adolescents are better able to directly express their thoughts and feelings, cognitive-behavioral therapy [as described below] will be the primary approach. For adults, the primary approach is also cognitive-behavioral therapy. However.

For couples, I help them gain insight into their problems and concerns, to understand the bases for a good relationship, improve communication, and set goals. In all of the therapy, "homework" practice of new skills is also employed.

My approach to Cognitive-Behavior Therapy
I employ an individualized, collaborative, problem-solving approach. This involves identifying current issues; understanding the influence of, and resolving, the past; changing present thoughts, feelings, and behaviors; and, working toward future goals.

I help you to understand what factors contribute to your, or your child"s, problems and concerns and what changes may be helpful. I guide and coach you in progressive steps to bring about lasting change.

In general, I help you examine the past and present to identify causes of your, or your child"s, difficulties and to help increase insight and understanding. We review the present situation to identify factors that need to change or improve. We also set goals and plan for the future. I teach positive, adaptive, and effective ways to think and act. You will practice these in your daily life between sessions, and we will refine them together.

Frequently Asked Questions

Q: How do I make an appointment?
A: Call me at (808) 255-3618. You may get my voice mail, especially if I am in session. I usually return calls the same day.

Q: Isn"t seeking professional help a sign of weakness?
A: Unfortunately, few of us learn all of the adaptive coping, personal, interpersonal, parenting, and social skills that we need to live in today"s complex world. Or, we may have developed some inappropriate or maladaptive skills. Therapy helps you develop the skills and strategies that you need to live a happier and more fulfilling life.

Q: How long will it take?
A: The duration of therapy varies depending on the types of problems you are experiencing and their severity. You should have gained some insight and made some progress in about 5 sessions. Initially, I will see you every week. As you make progress, the frequency will be reduced to once every 2 weeks. Ultimately, the frequency will be further reduced and discharge planning will be initiated.

It helps to think of therapy as having a beginning, middle, and end. Initially, together we review your history and current status and identify what issues and goals we will be working on. Then, we improve your insight and understanding, implement changes, develop better coping skills for you, etc. Finally, we maintain and build on gains, and eventually end therapy.

Q: Can I use my insurance?
A: Yes, I accept most health plans including Kaiser, HMSA, HMAA, HMA, UHA, and QUEST. If you do not have insurance, or prefer to self-pay, a sliding scale fee is available.

Q: How much will it cost me?
A: Depending on your health plan, your co-payment can range between $0 and $25 per session. This is determined by your insurance company.

Q: Will the content of our sessions and my records be confidential?
A: Yes. The content of our sessions is protected by state and federal laws. There are exceptions such as when a client poses imminent danger to self or others or when I am court-ordered to reveal information. I will discuss confidentiality during our first session.

Q: What if I"m not satisfied with my progress?
A: It is important to have a good match between psychologist and client. Feel free to address this at any time with me. If you would like to change therapists, I will refer you to another qualified therapist.


What is it?

Psychotherapy is a process in which a trained professional enters a therapeutic relationship with a client to help him or her to resolve emotional and behavior problems, relationship difficulties, parenting and family concerns, and the like. In general, any problem or issue that a child, adolescent, adult, parent or couple cannot cope with on their own may be addressed in therapy.

There are many misconceptions about therapy. Therapy is not just for "crazy people," it does not simply involve the client talking and the psychologist listening, or blaming everything on your past. It involves actively and collaboratively identifying problems and their causes, gaining awareness and insight, and taking active steps to bring about lasting change in your life.

Psychotherapy addresses personal, relationship, and family difficulties, providing the opportunity for individuals, couples, and families to openly and confidentially address their concerns and feelings with a professionally-trained individual. Clients are also encouraged to do homework assignments, applying their new knowledge and skills, between sessions.

Can I help you?

Who can benefit from psychotherapy?
Anyone who is having difficulty coping with the demands and stresses of life can be helped. If you or your child has emotional or behavioral problems, therapy can help.

Signs that you, or your child, may benefit from therapy:
• You are facing situations which are causing you or your child stress, anxiety, sadness, or anger.
• You or your child is experiencing feelings that seem more intense or uncomfortable than usual, or beyond your control, such as anger, sadness, fear, frustration and depression.
• You, or someone you care about, is behaving in ways which seem unusual or inappropriate, or are problematic to you or others.
• Your thoughts are peculiar, hard to understand, out-of-control, or disturbing.
• You or a family member has been subjected to a traumatic experience (such as an accident, assault, or abuse) or major loss (such as job loss, separation, divorce, or death).
• You are dealing with relationship issues, ongoing family conflicts, or difficult life transitions.
• You are challenged by family issues, such as parenting, child-rearing, or "troubled teens."


How should you choose a psychologist?
Learn what you can about the psychologist--from their website and other sources on the internet, your physician, a friend, etc. Look for a psychologist, with a PhD from a reputable school, who has experience treating the problems that you or your child has.

When you talk to him or her on the phone and during your first appointment, ask yourself if you feel comfortable with this professional. Observe whether the psychologist treats you as an individual or as a disorder. In other words, are you a human being or an abstraction to him or her? Note how knowledgeable the psychologist is, if he or she really listens to you, is attentive to your needs, and is willing to answer all of your questions. These factors will be significant throughout the course of therapy.

When should you switch psychologists?
If at any time, for any reason, you feel uncomfortable with your psychologist you should discuss this with him or her. One reason for discomfort is that in therapy you may need to talk about painful events in your life or accept that you need to change in significant ways. This can be especially difficult for parents. This is understandable. However, if you feel unhappy because of your psychologist"s style you should draw this to his or her attention and be satisfied with the outcome of your discussion. If the psychologist adopts a high-handed manner, becomes defensive, or in some other way avoids the issue, you should switch to another psychologist.

You should also switch if you are unhappy with your psychologist"s approach or the rate of progress. Depending on the nature of your, or your child"s, problems and how long you have had them, therapy may take months or, for chronic problems, years. However, you should have gained some insight, have experienced some relief, and have observed significant changes in your daily life within a few weeks of starting therapy. If not, express your concern to your psychologist and if you are not satisfied with the response, you should change psychologists.

You should also change psychologists if you find that he or she spouts a lot of jargon (that is, does not seem to think for himself or herself and does not treat you as an individual). A psychologist should be able to frame your problems and their treatment in a language that you can understand and relate to. If he or she uses words, images, analogies, etc that seem odd or obscure, ask for clarification or elaboration. If you continue to feel uncomfortable with the language used, move on!

Above all, you should feel an improvement in your life AND have begun to implement new or improved skills, including effective coping strategies. If you, or your child, or your relationship with your spouse, partner, or child has not improved, you should consider switching psychologists.

If your psychologist appears to be more of an entertainer than a therapist, if he or she employs questionable methods (for example, playing games with your child that appear to have no therapeutic value or encouraging your child to express his or her anger by yelling, hitting inflatable toys, destroying paper products, etc--all of which are contraindicated for anger management), if you and/or your family members enjoy your sessions because they are "fun," or you get along well during sessions, but your daily lives show no significant changes, you should switch psychologists. Also, if your psychologist likes to tell you his or her personal or family problems, he or she is wasting your time!

You may not know what to expect in therapy, or if what your psychologist is doing is the best approach for your problems, or what alternatives are available. However, not all psychologists are equally intelligent, educated, and experienced. Psychologists are humans, too. The bottom line is that you and your psychologist should be a good match AND you should make good progress. If it doesn"t feel right and you are not getting what you want out of therapy, don"t second-guess yourself; move on!

Or Psychiatrist?

What is the difference between a Psychiatrist and Clinical Psychologist?
The psychiatrist gets paid more! [That"s a joke I tell my students.]

A Psychiatrist is a professional who has had medical training. Psychiatrists prescribe medication; some also provide psychotherapy. A Clinical Psychologist has a Doctorate in Clinical Psychology and provides psychotherapy. Additionally, Clinical Psychologists may conduct psychological testing. Both psychiatrists and psychologists may provide diagnostic evaluation reports. In Hawaii, Psychologists do not prescribe medication.

Psychotherapy may be sufficient to help you with your problems. Medication may or may not be effective or sufficient for you. Sometimes, a combination of medication and psychotherapy is the most effective treatment. If you are being treated by a psychiatrist and are not receiving therapy but feel you need it ask if he or she provides therapy. If not, ask for a referral to a psychologist. Likewise, if you are being treated by a psychologist but find that you are not getting sufficient relief from some symptoms (such as, depressed mood or anxiety), or may otherwise need medication, ask your psychologist for a referral to a psychiatrist.

You do not need to stop therapy when you start medication. Medication may provide relief from symptoms but it cannot resolve issues that affect your life or teach you coping skills and adaptive behaviors. Therapy can.



Everyone gets sad sometimes usually in response to a setback, disappointment, failure, or loss. This is a normal reaction. However, sometimes, sadness endures; it may do so indefinitely at a milder level, may persist at a mild level with a single episode or recurrent episodes of depression, or a person may experience cycles of relative normality with moderate or severe depression. The symptoms of clinical depression include depressed mood and at least 4 of the following: diminished interest or pleasure, significant weight loss or gain, sleep problems, fatigue or lethargy, restlessness, worthlessness or guilt, difficulty with concentrating and decision-making, and thoughts of dying.

It is in the interest of pharmaceutical companies to promote the idea that depression is biologically-caused and must be treated with medication. This is not necessarily true. Medication may be helpful in alleviating the symptoms of depression. However, this does not mean that a "chemical imbalance in the brain" is THE cause of depression (or even other disorders).

Also, while medication may help, no single medication helps every depressed person nor does every depressed individual respond favorably to medication. Moreover, no medication can teach you the coping skills and adaptive thinking that is necessary in order to prevent or alleviate depression.

That said, if you are depressed, or are prone to depression, you should have a medical examination. This is important because depression or depressive symptoms may occur as a result of certain medical conditions, prescription or illegal drug use, hormonal imbalances, and the like. You should consult your physician to be screened for possible medical causes.

Environmental factors are known to be related to many cases of depression. Often, depression has to do with unpleasant or painful childhood experiences and/or severe abuse or trauma later in life. In general, an individual who experiences depression lacks adaptive and effective coping skills.

Depression has been associated with neglect, abuse, and trauma. Neglect, i.e. lack of nurturing, makes it difficult for a child to develop a healthy sense of self. Abuse, whether psychological or physical, also results in a poor self-concept but can also result in anxiety. Life-threatening trauma or a violation of one"s sense of security can also precipitate depression.

Other factors that may lead to depression include a child having to take on the responsibilities of an adult. This tends to happen when one (or both parents) has a chronic or severe physical or mental illness or when a parent is a substance abuser or alcoholic. When children are forced to take on the primary role of running the home and/or when they are forced to take care of one or both parents, instead of being nurtured and supported, they fail to develop a healthy self-identity.

A depressed person experiences extreme sadness, may have low self-esteem, engages in negative thinking, and may be subservient--putting the needs of others before herself (or himself, depression is more common in women), try to please others or gain approval, etc.

Therapy can help improve a person"s mood and self-esteem, teach adaptive and effective coping skills, and help prevent recurrence of depression. If you are depressed, I can help. Call me at 255-3618 to make an appointment.



The fundamental principle in effective parenting is consistency. Consistency lays the foundation for stability, self-control, and responsibility in children. You must be consistent in your expectations and consequences. It is better to have structure with some flexibility than too much or too little structure.

To begin with, your children should know what you expect from them regarding their conduct, schoolwork, and chores. By communicating expectations and consequences in advance, you will find it much easier to enforce your rules and guidelines. You must do this because it is the only way to avoid inconsistency on your part and avoidance or manipulation on their part.

In constructing your list of rules and guidelines, your guiding question should be "Is this reasonable and appropriate?". If you have more than one child, you should also answer the question, "Is this fair?". These questions are answered within the context of your resources--time, financial, etc. Structure is essential for regular and routine requirements. Additionally, whenever you need to make an "unscheduled" decision about your child"s or children"s "need" --a purchase, an outing, playtime, etc., ask yourself the same questions. If the answer is "yes, this is reasonable, appropriate, and fair" then say "yes"; if not, say "no" and stick with it.

Here is an analogy to clarify why consistency is so important. Think of your child"s whining, begging, tantruming, and the like as similar to the behavior of a telephone solicitor or door-to-door salesperson. If every single person hangs up or closes the door on the salesperson, that salesperson would have to go into some other line of work. This is because the salesperson would never get the attention he or she seeks and would never make a sale. However, if even 1 person out of 10, 20, 30, or even more gave the salesperson attention and/or made a purchase, the salesperson has reason to keep contacting and manipulating people. Sooner or later, someone is going to give in!

Similarly, if you give in even once to your child when he or she tries to manipulate you, your child will have reason to keep trying to get his or her way again and again. He or she has made a "sale" and achieved the desired result. [Note that children may not be deliberately manipulative; rather, with experience they learn what works.] If, however, "yes" means "yes" and "no" means "no," no matter how much your child begs, pleads, annoys, or charms, you retain control and your child has no incentive to keep working on you because you are not "buying."

By using the question "Is it reasonable, appropriate, and fair?" as your guide, you also avoid the inconsistency that results from you letting your mood, fatigue, guilt, etc result in your giving in to a child"s "demands." One more thing, always use a calm voice when instructing or correcting your child. Never ever raise your voice. Save the high-pitched voice for praise; use a low-pitched voice for direction and discipline.

I can teach you how to implement these effective principles and much more, such as how to get what you want without ever yelling, threatening, or hitting. Give me a call at 255-3618 to make an appointment.


Every relationship must have certain elements to be successful. These elements are good communication, respect, trust, fairness and appreciation, acceptance, companionship, and a bond. This applies in every relationship--intimate, parent-child, sibling, work, team, etc. However, the nature of the elements depends on the type of relationship. For example, an intimate relationship would include affection, love, and intimacy. Whereas a work relationship may involve a more general bond or, sometimes, friendship. [Of course, sometimes intimate relationships begin at work, as well.] If a relationship is missing any one of these factors, the relationship may be troubled. If two or more factors are poor the relationship is likely to be strained.

Good communication involves the ability to share thoughts and feelings and have them acknowledged and the reaching of a mutual understanding or agreement. Although there are gender-related differences, both individuals in a relationship want to be heard. Disagreements and conflicts in themselves are not a problem; rather, it is how these are discussed and resolved that have lasting effects on the relationship.

The nature of life and relationships is such that, sooner or later, a problem will arise. How each situation is dealt with is significant. If the two or more (family, team mates, coworkers, etc) individuals engage in arguing, yelling, swearing, and the like and/or if one or more individuals engages in generalizations or globalizations ("you always", "you never", "how many times have I .....?", "I hate you!"", etc) conflicts tend not to be resolved effectively and in a mutually satisfying manner. Moreover, each poorly resolved or unresolved situation can have a cumulative, damaging effect on the relationship.

Respect is an integral part of good communication. However, it is also more generally important in that each individual should feel appreciated and supported by the other(s) in the relationship. Respect is an attitude that is actively shown to each other. Trust is a feeling that develops implicitly from one"s interactions. Trust involves knowing that the other person(s) can be relied on, that you will not be betrayed, humiliated, or hurt in any way.
A sense of fairness or equality plays a role, as well. This feeling tends to be very subjective and is often a major source of conflict. Each individual needs to feel that he or she is treated fairly; that he or she is not "getting the raw end of the deal." If any individual feels that he or she is doing too much, has too much responsibility, that the other individual is lazy, selfish, uncaring, or irresponsible, and so on, there will be growing resentment and conflict.

Acceptance (or tolerance) is crucial in a relationship. Each individual has his or her own beliefs, preferences, bias, and quirks. These include religion, musical tastes, food preferences, style and appearance choices, hobbies, ways of coping, emotional reactions, mannerisms, and more. Each individual may or may not be willing or able to change any of these. When this is true, the other individual(s) must be able to accept, or even tolerate, the other person"s idiosyncracies. If a habit or choice is "part of who the person is" then one has to learn to "live with it"", or reach a compromise. Otherwise, conflict will keep arising. In other words, there is no point in getting angry or distressed by something that the other person cannot or will not change. Of course, in a parent-child relationship, parents have considerable influence over a child"s behavior. However, sometimes a child (or especially a teenager) may have a strongly held preference that, as long as it is not unhealthy or dangerous, may have to be accepted. Between adults, other than ending the relationship, there is no other way to resolve such differences.

Companionship, or "quality time"", involves having fun together. At work, for example, this may involve sharing jokes, celebrating birthdays, socializing, etc. At home, in addition to the above, companionship would include family time, romantic evenings, vacations, etc. To the extent that responsibilities and resources, such as time and money permit, the more quality time spent together the better. But remember, fun does not have to be expensive.

All of the other factors determine the strength of the bond that develops between the individuals involved. The better the communication, the stronger the respect and trust, the greater the acceptance, support, and perceived fairness, the more fun experiences shared together, the stronger will be the bond and the better will be the relationship.

If your relationship with your partner or spouse or any family member or group member (co-worker, teammate, etc) is weak in any of the above areas, I can help.

Courses That I Teach

Abnormal Psychology
A study of the etiology, development, manifestations, and treatment of psychological disorders. Psychodynamic, behavioral, humanistic, systems, and cross-cultural theoretical perspectives are used to understand stress and anxiety-based disorders, psychoses, social and personality disorders, and organic and developmental disorders. Normality/ abnormality are treated as concepts, as are legal and ethical issues related to deviant behavior.

Personality Theory
A study of the nature and development of human personality from different theoretical perspectives. Foci include: the conceptualization and meaning of "personality""; modes of assessing personality characteristics; and the relationship of personality to culture and society. Cases, contemporary research, and topics of current interest in personality are featured.

Social Psychology
An exploration of major theoretical paradigms as they are used to understand topics in social psychology, including social perception, attribution of causality, the self, emotions, attraction, prejudice and discrimination, attitude change, altruism, aggression, social influence, exchange and strategy, and physical well-being.

Learning and Cognition
A survey of the psychology processes in learning and cognition. This includes coverage of perception, attention, associative conditioning and other forms of learning, memory, language, creativity, reasoning, problem-solving, and decision-making. Students perform experiments to understand the methods of inferring these processes.

Tests and Measurement in Psychology
A course that covers the fundamentals of measurement theory and practice upon which all psychological testing rests. Major topics include: types of measurement, correlation, reliability, validity, test development and norms. Major individual and group tests of intelligence, personality, aptitude, and interests are examined and evaluated in terms of these concepts.

Statistics in Psychology
Provides skills necessary for data analysis in preparation for research methods course, and prepares students to analyze and interpret social science research findings. Students study descriptive and inferential statistics and parametric and nonparametric methods. Includes selection of proper statistical measures and techniques, and use of popular computerized statistical packages.

Research Methods
Familiarizes students with principal research approaches, including descriptive, correlational, and experimental techniques and the strengths and limitations of each methodology. Includes hands-on experience in the formulation of proper research design, data collection and analysis, and professional communication of results and conclusions.