Karena Franses, LCSW

Karena Franses is a Licensed Clinical Social Worker (LCSW) with 28 years of practice in California. She draws on a long clinical career in both hospital and private-practice settings to support people facing addiction, mood concerns, relationship strain, and major life changes. She brings a calm, compassionate presence and a belief that each person carries the seeds of their own recovery.

Her early career included long-term work in a county hospital HIV clinic where she supervised social work services for a large patient population. That role exposed her to end-of-life care, complex addiction, trauma, and the effects of social marginalization. Later she maintained a small psychodynamic self-psychology influenced practice in San Francisco, seeing individuals and couples for relationship and emotional concerns.

Karena uses Motivational Interviewing when readiness to change is central, helping people find motivation to reduce substance use or adopt healthier habits. She also draws on psychodynamic ideas to understand long-standing patterns in relationships, self-esteem, and identity. Her daily meditation practice and long-term Buddhist practice inform a gentle, nonjudgmental stance in sessions.

She has worked with many people affected by HIV and AIDS, hospice and end-of-life issues, caregiving stress, and cancer-related concerns. Other areas often addressed in her work include anxiety, depression, bipolar symptoms, grief, body image, eating issues, and codependency. She is comfortable talking about intimacy, communication problems, and life purpose.

Karena aims to listen closely and help clients clear the obstacles that keep them from feeling more alive. People who want a reflective, steady therapist who values kindness may find her approach helpful. If you are a caregiver looking for support, her background includes experience with caregiver issues and stress.

How her approaches shape online therapy

Karena uses Motivational Interviewing to help people explore and strengthen their own desire for change. This approach focuses on clear, guided conversations about goals and ambivalence and can be useful for addressing substance use, health behavior changes, and other situations where motivation is a key step.

She also draws on psychodynamic therapy ideas to look at long-standing patterns in relationships, self-image, and emotional reactions. That work involves gentle curiosity about past experiences and how they influence present behavior, which can help with persistent relationship issues, attachment concerns, and low self-esteem.

Finding the right approach is part of the process. She collaborates with each person to choose methods that fit their needs, goals, and preferences. Sessions can mix motivational techniques with reflective psychodynamic work as progress and priorities evolve.

The biography does not specify which online or in-person session formats are offered, so confirm current options before booking. Online therapy can make it easier to fit sessions into a busy life, save travel time, and allow for shorter check-ins when schedules are tight. It also gives therapists and clients flexibility to focus on what matters most during appointments.