Karena Franses, LCSW

Karena Franses, LCSW, is a California-based therapist who brings 28 years of clinical experience to her work with individuals and couples. She combines a long history of outpatient hospital supervision with private psychotherapy practice, drawing on both Motivational Interviewing and psychodynamic self-psychology perspectives to address issues such as addictions, relationship difficulties, grief, depression, anxiety, and challenges with intimacy and self-esteem. LCSW stands for Licensed Clinical Social Worker, a credential that reflects advanced training and state licensure to provide psychotherapy.

For 21 years she served as a social work supervisor in a busy outpatient HIV clinic in San Francisco that cared for roughly 2,800 patients. That role involved supporting people through addiction, trauma, depression, and the effects of systemic challenges like racism, homophobia, poverty, and homelessness. In private practice she worked with individuals and couples on overlapping concerns - addiction, relationship problems, body image struggles, self-harm, trauma, and abuse - refining both practical counseling skills and longer-term exploratory work.

Her clinical approach is informed by a personal and sustained Buddhist practice; she meditates daily and often cites the Dalai Lama's teaching that "Kindness is my religion." That practice has shaped a therapeutic stance rooted in humility and compassion, and she approaches therapy with the belief that each person holds the essential resources to heal. Her work focuses on helping people clear the obstacles that obscure their capacity for relief and resilience, whether the concern is coping with life changes, managing mood disorders such as bipolar or depression, or addressing addiction and caregiver stress.

Karena appreciates the many people who have shaped her career and values collaborative, attentive work with those seeking relief from suffering. She accepts clients in California and works with international clients as well, offering flexible ways to engage in therapy.

Therapeutic Approaches and Online Care

Motivational Interviewing is a collaborative, goal-oriented counseling style that helps people resolve ambivalence and strengthen their motivation to change. It is especially useful for addressing addictions, substance use, and other behaviors where clients may feel uncertain about change, and it emphasizes respect for each person's autonomy and readiness.

Psychodynamic Therapy invites exploration of patterns shaped by past relationships and life experiences to make sense of current struggles. It can be helpful for relationship challenges, intimacy issues, grief, low self-esteem, and recurring emotional patterns that interfere with daily life by increasing awareness of underlying feelings and relational dynamics.

Choosing the right approach is part of the therapeutic journey. Karena collaborates with each person to identify methods that best fit their needs, goals, and preferences, and she adjusts the work over time as growth and circumstances evolve. This collaborative stance helps ensure therapy remains relevant and effective for the individual.

Online therapy through video calls, phone sessions, live chat, or text-based messaging offers practical flexibility - it makes it easier to fit sessions into busy schedules, to maintain continuity when life changes, and to connect across distances. Licensed professionals can provide meaningful therapeutic support through these formats, enabling accessible care for clients in California and beyond.