About Karena
Karena Franses is a Licensed Clinical Social Worker with 28 years of experience in California. She combines long-term clinical work in hospitals and independent practice with a calm, compassionate presence. Her background centers on helping people manage addiction, anxiety, depression, and relationship struggles.
She aims to reduce suffering and help people find clearer ground. Karena brings practical experience from two main settings. She spent many years as a social work supervisor in an outpatient HIV clinic with a large patient population, where Motivational Interviewing was used frequently.
Background and approach
She later maintained a personal psychotherapy practice shaped by psychodynamic ideas and self-psychology. These different roles gave her experience with trauma, addiction, grief, and long-term life transitions. Her approach is steady and reflective.
She values kindness, empathy, and listening more than quick fixes. Sessions often involve talking through what keeps someone stuck, noticing patterns that repeat, and finding small, doable steps toward change. Personal practice informs her work.
A longtime Buddhist and daily meditator, she says compassion and humility guide her clinical choices. She believes answers often lie within the person and that therapy can help clear the clouds that block that insight. She has worked with people facing severe medical illness, hospice and end-of-life concerns, and the ripple effects of social stressors like homophobia, poverty, and isolation.
People reach out to address issues such as self-esteem, body image, grief, intimacy, and life purpose. Karena communicates plainly and respectfully. She helps people name their struggles and move toward relief, one step at a time.
Approach to change online and in conversation
Karena uses Motivational Interviewing to help people resolve ambivalence and find personal reasons to change. This approach focuses on listening, asking gentle questions, and identifying small, practical steps that feel doable for the person. It can be especially helpful for substance use, behavior change, and situations where motivation is mixed. She also draws on psychodynamic therapy to look at patterns that repeat over time. This work involves noticing recurring feelings and relationship dynamics and connecting them to past experiences. It is useful for understanding long-standing issues like attachment, repeated relationship problems, and chronic self-esteem concerns. Choosing the right approach is a collaborative process. The therapist will listen to your goals and preferences and suggest ways of working that match what you want to change. Together you can try strategies, reflect on what helps, and adjust the plan as needed. Online formats make scheduling and regular check-ins easier. Video calls support face-to-face conversation when you want visual connection. Phone sessions can fit a break at work or be used when bandwidth is limited. Live chat and text-based messaging offer shorter check-ins and ongoing support between longer sessions. These options aim to increase flexibility and help therapy fit into your daily life.Questions people ask
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What this therapist works with
Most often
- Addictions
- LGBT
- Relationship issues
Also listed
- Bipolar disorder
- Body image
- Cancer
- Caregiver issues and stress
- Codependency
- Commitment issues
- Communication problems
- Coping with life changes
- Depression
- Drug and alcohol addiction
- Eating and food-related issues
- Grief
- Guilt and shame
- HIV / AIDS
- Hospice and end-of-life counseling
- Intimacy-related issues
- Isolation / loneliness
- Jealousy
- Life purpose
- Self esteem
- Stress, Anxiety
Therapeutic approaches
- Experience
- 28 years
- Licensed
- California
- Languages
- English
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