Karena Franses


About me

Welcome and thank you for taking the time to read my profile page.

It has been my aspiration and commitment through my work life to collaborate with those seeking help and together make every effort to understand what is causing the suffering and in doing so to find some relief from the pain.

I have been a practicing Buddhist for many years, and I meditate daily. I love that His Holiness the Dalai Lama said, “Kindness is my religion," because we all need it, we all benefit from it when we give it and receive it and without it life is just harder and lonelier.

Buddhism informs my life and therefore my work. It has helped bring humility and compassion to my life and work. I believe that the answers to each person’s suffering lies within themselves. Most work involves clearing the clouds that mask the liberation in each of us.

My work life has played out in two quite different areas of care. The first was a county hospital, and the second a private practice, both in San Francisco. I worked for 21 years as a social work supervisor in a busy outpatient HIV clinic with 2,800 patients. Motivational Interviewing was the most effective type of counseling to use with the population we worked with. In the other setting, I had a small psychodynamic self-psychology informed psychotherapy practice, working with individuals and couples. Both settings offered me the opportunity to discover, explore and develop different skills as I encountered the vast diversity of human experience, where pain, trauma, and resilience came together as a gift to be tended with care, love, and compassion.

At the hospital AIDS clinic, we were initially faced with dying patients so much of the work involved just being with the dying. As fewer patients died when the medications improved, we were then faced with issues of severe addiction, trauma, depression, and a population who had experienced ongoing racism, homophobia, poverty, and homelessness. At my private practice, I met with clients who presented also with addiction issues and in addition those with relationship problems, impact of homophobia, body image issues, self-harm, trauma, and abuse.

I could never have imagined such a career when I started out. Now I feel deep appreciation and gratitude to all the clients and patients I served on this path. To all those who shaped my career, and taught me how to be a social worker and therapist through their kind and generous feedback, which at times let me know how much I meant to them, and at other times how I missed an opportunity to be empathic.

I hope we get a chance to meet and explore whatever issues are of most concern to you and together work to clear the clouds and find relief.

Thank you again for your kind attention.


  • Addictions
  • LGBT
  • Relationship issues
  • Grief
  • Self esteem
Also experienced in:
Stress, Anxiety , Intimacy-related issues , Bipolar disorder , Depression , Coping with life changes , Body Image , Cancer , Caregiver Issues and Stress , Codependency , Commitment Issues , Communication Problems , Read more...

Clinical approaches:
Motivational Interviewing, Psychodynamic Therapy

Years of Experience: 25

Services offered

  • Messaging

  • Live Chat

  • Phone

  • Video


CA LCSW 18975


These quotes represent just a few of the many positive reviews that we have received for Karena Franses. We don’t pay anyone to provide their review and they are all made voluntarily. Some people's experience receiving therapy with BetterHelp might be different.

Written on May 12, 2022 after therapy with Karena for 1 year and 1 month on issues concerning depression, stress, anxiety, relationship issues, family conflicts, trauma and abuse, grief, intimacy-related issues, eating disorders, parenting issues, self esteem, anger management, and compassion fatigue

Karena is thoughtful, patient, and compassionate in the way she provides care. I have grown so much this past year with her help and partnership and would recommend her without hesitation.

Written on Mar 06, 2021 after therapy with Karena for 4 months on issues concerning depression, stress, anxiety, addictions, lgbt, relationship issues, family conflicts, trauma and abuse, grief, intimacy-related issues, parenting issues, self esteem, bipolar disorder, coping with life changes, compassion fatigue, and adhd

An open view of things and was very helpful in a hard time.

Written on Feb 08, 2021 after therapy with Karena for 2 months on issues concerning relationship issues, and intimacy-related issues

Karena is wonderful!! She listens and empathizes so well - and yet has this amazing ability to challenge you in a kind, caring, respectful and helpful manner. That’s where the growth is for me.

I highly recommend Karena - - I wish she could be cloned lol! We need more people in this world like her.

Written on Jan 29, 2021 after therapy with Karena for 2 weeks on issues concerning relationship issues

Such a lovely caring lady providing the right combination of support, strategies and help ! Thank you Karena

Written on Dec 05, 2020 after therapy with Karena for 3 weeks on issues concerning stress, anxiety, relationship issues, and intimacy-related issues

Very good listener and insightful advice. I appreciate Karena’s pragmatism and empathy in our meetings. Has really helped
Me keep perspective whilst offer practical advice

Work with me!