- Addictions
- Psychodynamic Therapy
- Motivational Interviewing
About Karena
Karena Franses is a Licensed Clinical Social Worker (LCSW) in California with 28 years of practice. She works with adults on concerns such as addiction, relationship problems, grief, anxiety, depression, bipolar disorder, and issues around intimacy, self-esteem, stress, and coping with life changes.
Her background includes long experience in a county hospital and a private psychotherapy practice in San Francisco. For 21 years she supervised social work in an outpatient HIV clinic serving a large patient population. That work exposed her to severe addiction, trauma, depression, and the effects of poverty, homelessness, racism, and homophobia.
In private practice she saw individuals and couples for relationship struggles, body image and eating-related concerns, self-harm, and the impact of homophobia. She describes using Motivational Interviewing with the clinic population and psychodynamic, self-psychology–informed work in her private practice.
Franses has practiced Buddhism for many years and meditates daily. She says that this personal practice informs how she works, bringing humility and a focus on kindness. She believes the answers to suffering live within each person and that therapy often means clearing what obscures that inner resource.
Her approach is collaborative and reflective. Sessions include listening to a person’s story, identifying what keeps old patterns alive, and using conversation to motivate change or to uncover deeper emotional patterns. She draws on decades of direct care across medical and psychotherapy settings to shape what she offers.
How motivational and psychodynamic methods translate to online work
Motivational Interviewing helps people clarify ambivalence and connect their values to change. It uses conversational techniques to support decisions about behaviors such as substance use, treatment engagement, or making life changes.Psychodynamic therapy looks at patterns that repeat across relationships and over time. It helps people notice unconscious conflicts and emotional habits that contribute to shame, guilt, or relationship difficulties.
Finding the right approach often happens together. The therapist will discuss goals, try methods that fit the situation, and adjust as needed so the work reflects the client’s needs and preferences.
Because the biography does not list specific session formats, confirm current options before booking. Online sessions can make scheduling easier, allow a shorter check-in when time is limited, and remove travel time so therapy fits into a workday or caregiving routine. They also let people meet with licensed professionals when local options are limited. Practical considerations such as quieter surroundings, whether to be on camera, and session length can be discussed and arranged to match each person’s circumstances.
Areas of expertise
Primary focus
Also works with
Additional focus areas
Therapeutic approaches
Experience
28+ years
Listed in
California
Languages
English
Frequently asked questions
What concerns does she address related to guilt and shame?
She lists guilt and shame among many focus areas and works with related issues like body image, relationships, addiction, and grief.
How does she approach feelings of guilt or shame in sessions?
She uses conversational methods such as Motivational Interviewing and psychodynamic ideas to talk through what keeps those feelings active and what might help shift them.
How much clinical experience does she bring?
She has 28 years of practice, including 21 years supervising social work in an outpatient HIV clinic and years in private psychotherapy work.
What are her professional credentials and location?
She is an LCSW licensed in California and practices from that state.
Does she work in languages other than English or with international clients?
Sessions are offered in English and she accepts international clients.
Which session formats are used for meetings?
The original biography does not specify exact session formats; please confirm current session options before booking.
How are fees handled?
Cost varies with location and sessions use a subscription that can be canceled at any time.
What are the first steps to begin working together?
Select the See online therapy options button, complete a short matching questionnaire, and schedule a first session.
Online talk therapy is not emergency care. If you are in danger or thinking about harming yourself, use the crisis numbers.