Karena Franses , LCSW

Karena Franses brings decades of compassionate clinical work to people facing addiction, relationship challenges, grief, mood disorders, and major life transitions. She approaches each person with a belief that the answers to suffering often lie within, and she works collaboratively to help clear the clouds that mask a person’s natural capacity for resilience and relief.

A longtime practicing Buddhist who meditates daily, she integrates humility and compassion into her therapeutic stance. Those influences shape her emphasis on kindness, presence, and respect for the whole person as she helps clients navigate guilt, shame, body image concerns, caregiving stress, and intimacy-related issues.

Her professional background spans both public and private settings in San Francisco. For 21 years she supervised social work in a busy outpatient HIV clinic serving 2,800 patients, where Motivational Interviewing proved especially effective with people struggling with addiction, trauma, and complex social challenges. In private practice she developed a psychodynamic, self-psychology informed approach working with individuals and couples, addressing relationship patterns, trauma, self-harm, and the long-term effects of homophobia, poverty, and homelessness.

She values the lessons learned from patients and clients across these settings and expresses deep gratitude for those experiences. Karena holds the LCSW credential - Licensed Clinical Social Worker - and brings a blend of practical skills and reflective, empathic engagement to her work. She welcomes the opportunity to explore whatever issues are most pressing and to support steps toward greater relief and clarity.

Therapeutic Approaches and Online Care

Karena Franses commonly integrates Motivational Interviewing and psychodynamic therapy into her work. Motivational Interviewing is a collaborative, goal-oriented method that helps people resolve ambivalence and strengthen their own motivation for change - it is often used with addiction, behavior change, and readiness-related concerns. Psychodynamic therapy explores patterns rooted in early relationships and internal experience to increase self-understanding and relieve recurring emotional difficulties - it can be helpful for relationship problems, depression, and longstanding patterns of shame or self-criticism.

Choosing the right approach is a collaborative process. She works with each person to identify which methods fit their goals, history, and preferences, adjusting strategies over time as needs evolve.

Online therapy through video calls, phone sessions, live chat, or text-based messaging offers practical flexibility for people managing busy lives, caregiving responsibilities, geographic distance, or mobility limits. These options allow ongoing access to support and continuity of care while preserving the therapeutic focus on growth, coping, and improved well-being.