About Karena
Karena Franses is a licensed clinical social worker with 28 years of experience in California. She brings a calm, compassionate presence to sessions and emphasizes kindness as a starting point for change. Many people seek her help for addiction, mood challenges, relationship struggles, and stress-related problems.
Karena uses practical conversation to help people identify what keeps them stuck. She listens for patterns that affect mood, choices, and intimacy. Sessions often focus on small, achievable changes and on understanding the feelings beneath difficult behaviors.
How Karena works
Her background includes long work in an outpatient HIV clinic and a personal psychotherapy practice in San Francisco. That mix of settings shaped her focus on addiction, grief, and the emotional effects of stigma and loss. She draws on decades of experience supporting people through life changes and serious health concerns.
Therapeutic approaches include motivational interviewing and psychodynamic therapy. Motivational interviewing helps people find their own reasons to change. Psychodynamic work looks at how past experiences shape current relationships and feelings.
Karena welcomes conversations about body image, caregiver stress, eating issues, codependency, and questions about life purpose. She aims to create a steady space to talk, reflect, and try new ways of coping. If you want an empathetic, experienced clinician who values curiosity and steady support, she offers that alongside straightforward, practical guidance.
Karena lists 2 ways of working on the entry:
What Karena works with
The areas below are the ones Karena selected when setting up a profile. The first few are listed as the main focus; the rest are also named.
- Addictions
- LGBT
- Relationship issues
Also listed
- Bipolar disorder
- Body image
- Cancer
- Caregiver issues and stress
- Codependency
- Commitment issues
- Communication problems
- Coping with life changes
- Depression
- Drug and alcohol addiction
- Eating and food-related issues
- Grief
- Guilt and shame
- HIV / AIDS
- Hospice and end-of-life counseling
- Intimacy-related issues
- Isolation / loneliness
- Jealousy
- Life purpose
- Self esteem
- Stress, Anxiety
Training and background
| Register | LCSW |
|---|---|
| Years in practice | 28 |
| Languages | English |
| Session format | Online: video, phone, live chat or messaging |
| Country | California |
Memberships and registers are shown as supplied; they are not licences, and this directory does not verify them.
Online support options
Approaches that translate to online care
Karena uses motivational interviewing and psychodynamic therapy in ways that adapt well to remote sessions. Motivational interviewing is a collaborative, goal-focused style that helps people find their own reasons to change and set small, practical steps forward. It works well for addiction, substance concerns, and making behavioral shifts.Psychodynamic therapy involves talking about patterns, relationships, and past experiences that shape present feelings. That approach helps when relationship patterns, grief, or long-standing emotional habits are part of the problem. These two approaches can be used together to address both immediate change and deeper understanding.
Finding the right approach is part of the process, and she treats it as a shared effort. The therapist will work with each person to choose techniques that fit their goals, comfort, and life demands. Sessions are collaborative and adjusted over time as needs evolve.
Online formats include video calls, phone sessions, live chat, and text-based messaging to suit different situations. Video is useful for fuller conversation and visual connection, phone calls can be easier when bandwidth is limited, and messaging works for brief check-ins or ongoing support between sessions. These options make therapy more flexible and easier to fit around work, caregiving, or medical appointments.
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Common questions
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A practical next step
Write down two things you would want to be different in six months. That is the most useful thing to bring to a first session, whoever it is with. If you would rather start now than keep reading, online sessions are the quickest route.
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