01 · Who Karen works with

Karen works with stress, Anxiety, addictions and relationship issues

Karen lists 12 specialisms and 11 further focus areas. Specialisms are the subjects Karen chose to list first, which is the closest a listing gets to “this is my actual practice”.

02 · In Karen's own words

What Karen says about the work

Reproduced in full and unedited - not summarised, not tightened, not rewritten in a house voice.

My counseling work focuses on helping you find relief from mental health and situational challenges while developing solutions that are uniquely yours. Often this involves exploring and changing patterns of thought and behavior that have become problematic. It is very common to respond to situations in an automatic way, having developed deep beliefs about ourselves, our worth and potential. These beliefs impact the way in which we face challenges and interact with each other. Using a blend of evidence based modalities, my approach is collaborative as we develop new perspectives that foster growth and change.

Having worked in community mental health, crisis and in international and military settings, I have experience helping clients manage various forms of anxiety, depression, stress, substance dependence, relationship issues, life transitions and challenges relating to cultural adjustment.

Our work together is directed toward achieving outcomes that reflect your own personal needs and values. I believe that effective therapy embraces various approaches and that each person is a resilient and active participant in the shaping of their own life.

Karen Gravel, on the BetterHelp listing · read 8 Nov 2026

03 · How Karen works

The 6 approaches Karen lists, in plain English

These are the clinical methods Karen lists. The descriptions are Maker Therapy's, not Karen's - a general explanation of what each method is, so the list means something before you have spoken to anybody. They are not a claim about how Karen runs a session.

Cognitive Behavioural TherapyCBT

Structured, present-focused work on the loop between what you think, how you feel and what you then do. Usually means noticing a thought pattern in the room, testing it against evidence, and practising something different between sessions. Among the most heavily researched talking therapies for depression and anxiety.

The Gottman Method

A couples approach built on decades of observational research into what distinguishes relationships that last. Structured and assessment-led: it maps friendship, conflict and shared meaning, then works on the specific mechanics of how the two of you argue.

Motivational InterviewingMI

A way of talking about change with somebody who is genuinely in two minds about it. The therapist does not argue for the change; they help you say your own reasons out loud, which is the part that predicts whether it happens. Common around substance use and health behaviour.

Narrative Therapy

Treats the story you tell about your life as something that can be examined and retold rather than as the plain facts. Separates the person from the problem - “the anxiety” rather than “your anxiety” - to make room for the parts the current story leaves out.

Solution-Focused Brief TherapySFBT

Starts from where you want to end up rather than from how you got here. Sessions look for the times the problem is already smaller and work out what is different about those, so the number of sessions tends to be short and the work concrete.

Internal Family SystemsIFS

Treats the mind as made up of parts - the critic, the one who withdraws, the one that keeps everything running - each of which is trying to protect you. The work is getting to know them rather than overruling them.

04 · What happens next

From this page to a first session

Karen practises through BetterHelp, so the route in is BetterHelp's. This is that sequence, written by Maker Therapy from the platform's published process - not a description of Karen's own practice, and not a promise about how quickly anything happens.

1. A questionnaire, not a booking form

   BetterHelp opens with a set of questions about what you are dealing with, what you want from therapy, and any preferences on the therapist. You are not booking Karen at this point.

2. Naming Karen specifically

   BetterHelp matches algorithmically by default, so asking for Karen is a step you have to take. There is a field for requesting a specific therapist during sign-up, and you can switch afterwards from your account. Starting from a link on this page does not by itself assign you to Karen.

3. If the caseload is full

   You will be offered somebody else rather than put on a waitlist. Worth knowing, because it is easy to assume a match is the person you asked for.

4. The first conversation

   A first session is typically history and orientation: what brought you, what has been tried, what you want to be different. It is also where the questions in the next section belong.

5. If the fit is wrong

   Changing therapist on BetterHelp does not need a reason. A first session that does not click is common and is not a verdict on therapy. That option existing is the main practical difference between a platform and a private practice.

05 · Before you commit

3 questions worth asking Karen

Built from what Karen actually lists, so they are answerable and specific rather than generic. Maker Therapy's, not Karen's - Karen has not seen them and is under no obligation to answer any of them.

• “You list both Cognitive Behavioural Therapy and Narrative Therapy. Which do you lean on with someone like me?”

  Those two point in different directions - one structured and led by the therapist, the other led by you. The answer tells you what the sessions will actually feel like.

• “How do you decide when someone is ready to work on a traumatic memory itself?”

  Pacing is the biggest safety question in trauma work. A clear, unhurried answer here matters more than any credential.

• “How do you handle the gap between sessions if something comes up?”

  On BetterHelp this varies a great deal by therapist. Better to know the rhythm now than to discover it on a bad week.

06 · Practical details

Credentials and licensing

Credential

LMHC

Licensed in

Massachusetts

Licence

MA LMHC LMHC10861

Licence number

LMHC10861

Licence expires

31 Dec 2027

NPI

1265818751

Years in practice

8

Gender

Female

Languages

English

International clients

Accepted

Listed since

15 May 2026

07 · Provenance

Where every line on this page came from

Karen's name, credential, state, subjects, approaches and biography are read from BetterHelp's therapist roster, which Maker Therapy re-reads once a day; this page reflects the reading taken on 8 Nov 2026. The licence number and NPI are cross-checked against public registers.

The plain-English method descriptions, the first-session walkthrough and the questions are written by Maker Therapy and labelled as such wherever they appear.

Maker Therapy is not BetterHelp, does not take bookings, and has not met Karen. There are no reviews or ratings on this page because we have no way to verify one. If you start therapy through a link here, we may be paid a commission - it does not change your price and it does not affect who appears here or in what order.

Something on this page wrong or out of date? Report it and it will be checked against the source.