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- Motivational Interviewing
- Psychodynamic therapy
- HIV and end-of-life care
About Karena
LCSW in California with 28 years of experience, Karena Franses focuses on addictions, relationship difficulties, grief, mood disorders, and stress-related concerns. She uses Motivational Interviewing and psychodynamic therapy as her main approaches. Karena brings clinical experience from both hospital-based and private practice settings in California to her work.
Karena spent much of her career at a county hospital and an outpatient HIV clinic in San Francisco. She worked for 21 years as a social work supervisor in a busy clinic that served thousands of patients. That experience shaped her clinical skills in responding to addiction, trauma, depression, and the social pressures many patients faced.
In private practice she worked with individuals and couples on relationship problems, body image, self-harm, and the long-term effects of homophobia and abuse. Her practice background includes hospice and end-of-life counseling, caregiver stress, and support for people living with chronic illness including HIV and cancer.
Her day-to-day style blends short-term, goal-focused conversations with deeper, psychodynamic exploration. Motivational Interviewing is used when clients need help finding reasons to change addictive or health-related behaviors. Psychodynamic work is used to look at patterns that repeat across relationships and life choices.
Karena describes a contemplative personal practice influenced by Buddhism and daily meditation. That outlook informs how she listens and reflects, and how she helps people notice the patterns that get in the way of their wellbeing.
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How her approaches translate to online sessions
The therapist uses Motivational Interviewing to help people find motivation for change. In short conversations she helps clients weigh pros and cons, identify goals, and build momentum for healthier behavior. This approach is commonly used for substance use, health-related change, and other behaviors where finding personal reasons to change matters.Psychodynamic therapy is used to examine repeating patterns in relationships and internal experiences. Sessions can focus on how past experiences shape present choices and on uncovering recurring emotional themes that influence behavior. This work can be helpful for relationship problems, issues with intimacy, and longstanding mood concerns.
Karena treats selecting an approach as a collaborative process. She will discuss goals and preferences with each person and adjust methods as the work unfolds. Finding the right balance between short-term change work and deeper exploration is part of the first sessions.
The biography does not specify which online formats are offered, so confirm available session types before booking. Online sessions can make it easier to fit therapy into a busy life - for example a shorter check-in during a break, not having to travel, or choosing a conversation that does not require video. These practical benefits often help people maintain consistency while they work on addictions, mood, grief, or relationship concerns.
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Areas of expertise
Primary focus
Also works with
Additional focus areas
Therapeutic approaches
Experience
28+ years
Listed in
California
Languages
English
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Frequently asked questions
What concerns does she help with?
She works with addictions, anxiety, depression, bipolar disorder, grief, relationship and intimacy issues, and coping with life changes among other concerns.
What therapeutic approaches does she use?
Sessions draw on Motivational Interviewing and psychodynamic therapy. Motivational Interviewing is used to support change efforts and psychodynamic work examines recurring patterns in relationships.
How much clinical experience does she have?
She has 28 years of clinical experience, including long-term roles in both hospital outpatient care and private practice.
What are her credentials and where is she based?
She is an LCSW (licensed clinical social worker) in California and practiced extensively in the San Francisco area.
Which languages are sessions offered in?
Sessions are offered in English and she also accepts international clients.
What session formats are available?
The original biography does not list specific session formats. Please confirm current session options before booking.
How is cost handled?
Cost varies with location; sessions use a subscription that can be canceled at any time.
How do I begin working with her?
Start by selecting the See online therapy options button, completing a short matching questionnaire, and scheduling a first session.
Online talk therapy is not emergency care. If you are in danger, use the urgent help numbers.