Karena Franses

Karena Franses is a Licensed Clinical Social Worker (LCSW) in California with 28 years of clinical experience. She has worked in both hospital and private-practice settings and lists addictions, relationship concerns, grief, anxiety, depression, bipolar disorder, stress, intimacy issues, and life purpose among her core areas of focus.

She spent over two decades as a social work supervisor in a busy outpatient HIV clinic in San Francisco and later maintained a small psychodynamic psychotherapy practice. That mix of settings exposed her to severe addiction, trauma, end-of-life care, and the ongoing effects of racism, homophobia, poverty, and homelessness on people’s lives.

Her approach draws on Motivational Interviewing and psychodynamic therapy. She describes using Motivational Interviewing especially in work with people facing addiction and behavior change. Psychodynamic ideas inform longer-term work on relationships, attachment, and unconscious patterns.

Karena describes a personal connection to Buddhist practice and daily meditation. She says that practice has shaped her bedside manner and professional outlook, bringing humility and a focus on kindness into sessions.

In practical terms she has supported people with body image and eating concerns, caregiver stress, cancer-related issues, HIV/AIDS and hospice and end-of-life counseling. She also lists communication problems, codependency, jealousy, commitment issues, and the emotional impacts of life changes.

Sessions are conducted in English and she accepts international clients. Cost varies with location and sessions use a subscription that can be canceled at any time. To begin, clients complete a short matching questionnaire and schedule a first session.

How her approaches translate to online sessions

Motivational Interviewing is a collaborative, goal-oriented way of talking that helps people resolve mixed feelings about change. It is often used when someone wants to cut down on substance use, start new routines, or stay committed to a plan. Psychodynamic therapy pays attention to recurring relationship patterns and early influences that shape how people react now; it can be useful for understanding why certain situations keep repeating and for improving intimacy and communication.

Finding the right approach is part of the work together. She will discuss options and try methods that match a person’s goals, needs, and preferences. That collaboration helps decide whether to focus first on practical change, on deeper pattern work, or both.

The therapist’s biography does not list specific session formats, so confirm current online options before booking. In general, online sessions can make it easier to fit therapy into a busy life - for example a shorter check-in during a work break or an appointment that avoids travel time. Some people prefer less visual contact and choose audio-only when available, while others use video for face-to-face conversation. Discussing what will work for schedules and energy levels is part of the first sessions.