Karena Franses

Karena Franses is an LCSW with 28 years of clinical experience in California. She has spent decades supporting people through grief, addiction, relationship struggles, and life changes. Her practice reflects long years in hospital and private settings, and she brings that history into each session.

Her work combines practical listening with gentle inquiry. She draws on Motivational Interviewing to help people find their own reasons to change. She also uses psychodynamic ideas to look at patterns that repeat in relationships and behavior. Sessions are aimed at helping people feel understood and find clearer ways forward.

Karena’s background includes many years as a social work supervisor in an outpatient HIV clinic in San Francisco. That work involved supporting people facing serious illness, addiction, and loss, including time spent offering care to those nearing the end of life. She later maintained a private practice focused on individual and couple work and on issues such as body image, trauma, and self-harm.

Her therapy voice is shaped by a long personal practice of Buddhism and daily meditation. This brings an emphasis on kindness, patience, and humility in sessions. She believes answers often come from within and that therapy can help clear what obscures them.

People who choose her tend to want thoughtful, steady support for anxiety, depression, relationship questions, grief, or struggles with substance use. To begin, readers are invited to use the site Start Therapy flow to complete a short questionnaire and arrange an initial meeting.

Approaches that guide online care

Karena uses Motivational Interviewing and psychodynamic therapy as core approaches. Motivational Interviewing is a collaborative, goal-focused method that helps people find their own reasons to make changes, often useful for substance use and behavior change. Psychodynamic therapy looks at repeating patterns in relationships and emotional life to help people understand how past experiences shape present choices.

Choosing the right approach is part of the work together. The therapist will help identify which methods fit a person’s needs, goals, and preferences, and will adjust the plan as therapy progresses. That process is collaborative and unfolds at a comfortable pace.

Session formats are not specified in the biography, so confirm current options before booking. Online therapy can make it easier to fit sessions into a busy life by reducing travel time, allowing shorter check-ins when schedules are tight, and letting people join from different locations or time zones. It also supports continuity of care when life changes make in-person visits difficult. Ask about specific scheduling and format choices when arranging the first appointment.