Karena Franses

Karena Franses is a Licensed Clinical Social Worker with 28 years of practice in California. She combines many years in hospital care with private practice experience. Her work often focuses on substance use, relationship strain, mood concerns, and issues around eating and body image.

She approaches therapy with steady compassion and a calm, reflective style. Meditation and Buddhist practice shape how she listens and interacts. She believes people already hold answers inside themselves and that therapy helps clear what blocks those answers.

Karena spent over two decades as a social work supervisor in an outpatient HIV clinic in San Francisco. That role involved supporting people through grief, addiction, and the effects of stigma and social hardship. She also ran a private practice offering longer-term psychodynamic work and short-term counseling when needed.

Clients come with many kinds of pain - depression, anxiety, bipolar mood changes, grief, relationship problems, and stress from caregiving or life change. She regularly addresses concerns such as codependency, communication problems, intimacy challenges, and substance use. Eating and food-related issues and body image are also listed among her focus areas.

In sessions she uses Motivational Interviewing and psychodynamic ideas to help people find motivation and to notice patterns that keep them stuck. She aims to be present, honest, and gently curious while helping people sort through their feelings and make practical changes.

To begin she invites a straightforward conversation about what matters most to the client and works at a pace that fits each person’s needs.

How her approaches guide online therapy

Karena uses Motivational Interviewing to help people find their own reasons to change. This approach focuses on gentle questions, listening for what matters, and building motivation step by step. It can help with substance use, procrastination around change, and finding a next small move.

She also draws on psychodynamic therapy to look at repeating life patterns and early relationship influences. This work helps people notice how old ways of relating show up now and how those patterns affect mood, intimacy, and self-esteem.

Finding the right approach is part of the process. She works collaboratively to see whether motivational work, psychodynamic exploration, or a mix fits a person’s goals. Clients and the therapist set goals together and adjust direction as progress unfolds.

The therapist biography does not specify which online session formats are offered, so please confirm current options before booking. Online sessions can make it easier to fit therapy into a busy week, enable shorter check-ins when needed, and remove travel time so work or caregiving responsibilities are easier to manage. Licensed professionals adapt methods so the work stays focused and practical even when happening remotely.