Mental Health / Therapy / School Concerns

Telemed Link for Therapy Appointments

Click here to join our therapist for your telemed therapy appointment.

Please review the Hirsch Pediatrics telemedicine consent form before starting your appointment.

In-Network Therapy at Hirsch Pediatrics

As our society and families confront staggering mental health challenges, Hirsch Pediatrics is ready to meet the therapy needs of our families!  We are excited to have, Diana Kochan, LMFT, who joined the Hirsch Pediatrics in 2020, provide full-time IN-NETWORK** therapy dedicated to Hirsch Pediatrics families for both children and parents.  Immediate openings are available Monday – Friday (hours vary by day) and are offered both in-person and by video telemedicine. Space is limited so please contact us ASAP for more information or to request a session.

What services are available?
As a Licensed Marriage and Family Therapist (LMFT), Diana has extensive experience in individual child, adult, and family therapy.  Her expertise includes optimizing family dynamics and developing strategies to help both your child and family thrive emotionally.  Diana is available to support Hirsch Pediatrics families by providing the following services:

*   Therapy for adolescents and young children struggling with anxiety, depression, and/or anger management.

*   Families struggling with difficult child behaviors of all ages.

*   Individual sessions for parents seeking coaching around managing very difficult toddler behaviors.

*   Short-term post-partum depression therapy.

*   Direct therapy to parents dealing with family dynamic challenges including new babies.

*   Therapy and coaching to help families manage a separation or divorce and the impact on children.

** Therapy services are in-network for most insurances including Blue Cross Blue Shield, CareFirst, Aetna, Cigna, and many other plans. At this time therapy services are not in-network for United HealthCare. For families with United HealthCare or self-pay families the cost of therapy is $150 per session. 

Together, Hirsch Pediatrics looks forward to helping your family thrive both physically and emotionally.

Meet Our Therapist - Diana Kochan, LMFT

Diana Kochan, LMFT, joined the Hirsch Pediatrics family 2020 to provide on-site counseling services to our patients and new parents suffering from anxiety, depression, and difficult behaviors at home or at school. Prior to joining Hirsch Pediatrics, Diana worked as a therapist providing solution-focused, short term counseling to at-risk children and military families. When working with a family, Diana’s additional training as a family therapist is invaluable to optimize family dynamics and develop proactive strategies for the child to succeed emotionally.

Diana holds an undergraduate degree in psychology from Guilford College and received her Master’s in Family Therapy from Drexel University in 2007. Diana lives in Montgomery County with her husband and daughter and in her spare time enjoys going for walks with the family, long runs and spending time with her loved ones.

“I am passionate about working with children and adolescents with behavioral and emotional challenges. I have experience helping families and individuals of diverse communities overcome various obstacles in their lives and have helped them achieve their desired goals.”

-Diane Kochan, LMFT

New Patient Therapy Consent Forms

Please complete and bring your Hirsch Pediatrics Therapy Consent Forms (sign at bottom of pages 2, 3, and 4) to your first therapy appointment. Additional consent form for our therapist to contact another mental health provider on behalf of your child.

School or Behavior Concern Evaluation at Hirsch Pediatrics

Because these concerns are complex and require much more time than is allotted at a typical sick visit or check-up, our providers at Hirsch Pediatrics are able to meet with parents for an extended 30 – 60 minute consultation appointment. Please note that this appointment will be without your child and is very important – whenever possible – for both parents to participate in the meeting. Our goal at this appointment is to learn in greater detail the scope of the issue and then to collaborate on a strategy to address the concerns. This strategy may involve working with the school or county resources, referral to a specialist, or a trial of medications.

In addition or instead of an appointment at Hirsch Pediatrics, many behavior concerns for young children under age 5 can be addressed through direct parenting interventions (“positive parenting”) alone or in combination with an appointment. The “positive parenting” motto is that “We don’t change their children. We change the parents, so they can change their children.” We have copied below several excellent parenting resources that we highly recommend, especially for families that are having difficulties with oppositional behaviors for children under age 5.

Amy McCready  is a nationally renowned parenting coach (www.positiveparentingsolutions.com) with extensive online courses and videos.

Dan Shapiro, MD is a local behavioral/developmental pediatrician (www.parentchildjourney.com) who offers local parenting courses and seminars that are extensive and inexpensive as well as individual onetime appointment assessments.

Megan Leahy, MEd is a local parenting coach (www.mlparentcoach.com) who offers phone consultations and online classes.

Claire Lerner, LCSW is a local social worker (www.lernerchilddevelopment.com) who specializes in difficult toddler behaviors and will also do home/school visits.

Steps to schedule an appointment to discuss school and behavior concerns:

Step 1: If you have any behavior or school concerns that may need a consultation appointment, please send us a detailed patient portal message explaining those concerns.

Step 2: In most situations, we will request that each parent and at least one teacher complete the Vanderbilt rating scale prior to the consultation appointment. Click on these links for the separate PARENT VANDERBILT and TEACHER VANDERBILT versions.

  • This simple questionnaire takes about 10 minutes to complete and can evaluate concerns relating to ADD/ADHD, oppositional defiant disorder (ODD), and anxiety/depression.
  • It is important that EACH parent fill out a separate survey as well as at least 1 -2 teachers.
  • Please make sure that all completed Vanderbilt rating scales are sent to us at least 2-3 days before the appointment.

Step 3: Once your Vanderbilt rating scales are completed, please contact our office to schedule your appointment. Note: Since these appointments require up to 60 minutes, we often need 3-4 week advance notice. Please note that this appointment will be without your child and is very important – whenever possible – for both parents to participate in the meeting. Our goal at this appointment is to learn in greater detail the scope of the issue and then to collaborate on a strategy to address the concerns.

Step 4: If you or the school has a concern about attention or a possible ADD diagnosis, prior to our meeting please click on the following KidsHealth link for extensive background information on the following areas:

Symptoms, Diagnosis, Causes of ADHD, Related Problems, Treating ADHD, Medications, Behavioral Therapy, Alternative Treatments, ADHD in the Classroom, Supporting Your Child and Yourself

Step 5: If after your extended appointment the decision is made to do a trial of medications, then a follow-up brief appointment with your child will be scheduled.

Step 6: For ongoing management, in most cases children on ADD or depression/anxiety medications will need a follow-up appointment with Hirsch Pediatrics every 3 months. These follow-up appointments can usually be done virtually by telemedicine. If you have significant concerns about your child’s current medications, please send us a portal message before your appointment so we can ensure the correct amount of time is allotted.

Mental Health Crisis: Suicidal Behavior and Keeping Your Child Safe

Advice from Dr. Hirsch and Diana Kochan, LMFT, on “Warning Signs for Suicidal Behavior:”

  1. Child has talked about wanting to die or kill themselves AND has a plan.
  2. Child has talked about feeling hopeless or having no reason to continue with living.
  3. Child has talked more about death.
  4. Client isolates more from family and friends and does not engage in activities that used to make them happy.
  5. Child has talked about being a burden to others and feels guilty about others caring for them.
  6. Child has said goodbye to friends and family.

Advice from Dr. Hirsch and Diana Kochan, LMFT, on “How to Keep Your Child Safe:”

One: Trust your gut, if something seems off with your child, go to them and directly ask them if they have thoughts of wanting to hurt themselves.

Two: ASK YOUR CHILD DIRECTLY “DO YOU HAVE ANY CURRENT OR PAST THOUGHTS ABOUT HURTING YOURSELF OR WISH YOU WERE DEAD? IF YES DO YOU HAVE A PLAN?”

***NOTE: Many studies have shown that directly asking your child these questions DOES NOT “put the thought in their head” or increase the chance of attempting suicide. In fact most children are relieved to be able to talk to a parent about these difficult thoughts.

Three: If your child tells you that they have currently want to hurt themselves and has a plan on how to hurt themselves, please go immediately day or night to have your child evaluated by a trained mental health provider in suicide crisis management. This immediate action can be life-saving.  In our area we have two excellent 24/7 resources for immediate mental health crisis evaluations:

Pediatric Emergency room at Adventist Shady Grove Rockville (9901 Medical Center Drive, Rockville, MD 20850, billed to health insurance)

Montgomery County Crisis Center (240-777-4000, 1300 Piccard  Drive, Rockville, MD 20850, free services)

Call or text 988 if you are not able to immediately seek care. Make sure your child also is aware of 988. 988 is the Suicide & Crisis Lifeline and offers 24/7 call, text and chat access to trained crisis counselors for people with suicidal thoughts or for those worried about a loved one who may need crisis support. LGBTQ+ suicide support also available 24/7 at the Trevor Project by live chat on the web, calling 866-488-7386, or texting START to 678-678.

Four: Let your child know that you are there for them and that they are not alone. If you are worried about your child’s imminent health then do not leave them unaccompanied until you are able to seek help. This includes sleeping in their bedroom and leaving the bathroom door open at all times.

Five: At home, reduce all access to any lethal items such as guns, pills, and knives. The actual act of suicide is an impulsive decisions often decided within seconds of the attempt so removing guns from the house is especially urgent.

Six: After being evaluated by a crisis counselor please contact us to schedule an appointment for ongoing therapy to help your family and child process their feelings. Hirsch Pediatrics patients have access to our in-house therapist Diana Kochan, LMFT, Monday to Friday.

Parenting Classes & Resources with Dr. Dan Shapiro

For parents of children with ongoing difficult emotional and behavioral concerns, in addition to setting up a consultation appointment with one of our therapists, Dr. Hirsch strongly recommends attending one or more of Dr. Dan Shapiro’s interactive workshops. Dr. Shapiro is a highly sought after local expert in Developmental-Behavioral Pediatrics and the creator of the ParentChild Journey.

Dr. Shapiro offers a wide range of evening parenting workshops with his team of experts. The workshops cover a variety of topics and are presented throughout the year in various locations. Payment is optional with a suggested contribution of only $20 – $30 per session.

Can’t attend a workshop but want to learn more? Dr. Shapiro’s website has all of his course and presentation information online in an extensive resource section.