Karena Franses , LCSW

Karena Franses is a licensed clinical social worker with a long career helping people navigate addiction, relationship struggles, grief, mood disorders, and the stresses that come with major life changes. She brings 28 years of clinical experience to her work and holds the credential LCSW - Licensed Clinical Social Worker - which reflects advanced training and clinical practice in social work.

Her professional path has included roles in both a county hospital setting and a private psychotherapy practice in San Francisco. For 21 years she supervised social work services in a busy outpatient HIV clinic that served roughly 2,800 patients. That work exposed her to dying patients early on and later to complex concerns such as severe addiction, trauma, depression, and the effects of racism, homophobia, poverty, and homelessness. In private practice she provided psychodynamic, self-psychology informed psychotherapy for individuals and couples, addressing issues including addiction, relationship difficulties, body image concerns, self-harm, trauma, and abuse.

Buddhist practice and daily meditation inform her approach, bringing humility and compassion to clinical work. She often draws on Motivational Interviewing with clients for whom change is challenging, and on psychodynamic ideas when exploring patterns in relationships and self-definition. Her clinical focus spans addictions, LGBT concerns, intimacy and communication problems, bipolar and depressive conditions, stress and anxiety, caregiving and end-of-life issues, and other areas where people seek clearer direction and relief.

Throughout her career she expresses deep appreciation for the people she has served and for the lessons they brought. She welcomes the opportunity to engage thoughtfully with those seeking to understand their suffering and to find pathways toward greater ease and meaning.

Integrating Motivational Interviewing and Psychodynamic Work Online

Karena Franses draws on Motivational Interviewing to support people who are ambivalent about change. This approach uses empathetic, goal-focused conversation to help clients clarify their values and strengthen motivation for steps like reducing substance use, improving relationships, or adopting healthier routines. Psychodynamic Therapy is another key approach she uses; it explores recurring patterns, early influences, and unconscious dynamics that shape how a person relates to themselves and others, which can be useful for longstanding relationship issues, intimacy concerns, and self-esteem struggles.

Choosing the right approach is a collaborative process. She works with each person to assess needs, preferences, and goals, and adapts methods over time so therapy fits what feels most helpful and practical for the individual.

Online therapy offers flexibility that suits many lifestyles. Through video calls, phone sessions, live chat, and text-based messaging, licensed professionals and therapists can provide consistent support without the need to travel to an office. This format can make it easier to maintain continuity of care, fit sessions into busy schedules, and access help from different locations while working together on recovery, relationships, and coping with life transitions.