Practitioner record · Checked 10 Oct 2026
Karena Franses has been in practice 28 years and is licensed in California. Karena lists addictions, LGBT and relationship issues among 24 subjects on the BetterHelp roster.
Everything below is either quoted from Karena's own BetterHelp listing, taken from public licensing records, or written by Maker Therapy and labelled as such. Nothing here is an availability promise, a review, or a rating.
01 · Who Karena works with
Karena lists 10 specialisms and 14 further focus areas. Specialisms are the subjects Karena chose to list first, which is the closest a listing gets to “this is my actual practice”.
02 · In Karena's own words
Reproduced in full and unedited - not summarised, not tightened, not rewritten in a house voice.
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.
Karena Franses, on the BetterHelp listing · read 10 Oct 2026
03 · How Karena works
These are the clinical methods Karena lists. The descriptions are Maker Therapy's, not Karena'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 Karena runs a session.
04 · What happens next
Karena 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 Karena's own practice, and not a promise about how quickly anything happens.
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 Karena at this point.
BetterHelp matches algorithmically by default, so asking for Karena 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 Karena.
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.
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.
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
Built from what Karena actually lists, so they are answerable and specific rather than generic. Maker Therapy's, not Karena's - Karena has not seen them and is under no obligation to answer any of them.
“With 28 years in, what has changed most in how you work?”
Long experience is only an advantage if it has been examined. This tends to surface whether it has.
“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
07 · Provenance
Karena'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 10 Oct 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 Karena. 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.
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