Karen Sharkey
I specialize in working with adults with ADHD, anxiety, and trauma, including clients who have spent years feeling overwhelmed, stuck, or frustrated with themselves without fully understanding why. I am a LCSW and an ADHD-Certified Clinical Services Provider (ADHD-CCSP). I use a combination of CBT, psychodynamic therapy, solution-focused therapy, and trauma-informed approaches to help clients better understand both what is happening now and where some of those patterns may have come from.
First session
Meeting a stranger on a screen and being expected to immediately talk about personal things is a little strange. I know that, and I don’t expect you to show up ready to tell me your entire life story. The first session is really about getting a sense of what’s going on, what brought you in now, and what you want to be different. I’ll ask questions, but there’s room for you to ask me questions too. We’ll talk about what has and hasn’t worked before, what feels most important right now, and where it makes sense to start. From there, we’ll develop goals together. I like goals that are realistic, flexible, and actually relevant to your life—not something we write down once and never look at again. You can expect me to listen, offer feedback and structure when it’s useful, and be straightforward with you while we figure out what may or may not work for you.
Strengths
My style is direct, collaborative...and human. Therapy doesn't have to feel overly formal, and you do not have to censor yourself or arrive with everything figured out. Humor is welcome, swearing is fine, and we can still do meaningful clinical work while talking like actual people. I also recognize that meeting a stranger online and immediately being expected to talk about deeply personal things can feel awkward and vulnerable. I don't expect instant trust. We'll take time to understand what you need from therapy, what has; and has not, worked for you before, and what would make treatment genuinely useful in your day-to-day life.
Ideal clients
My ideal client is someone who is overwhelmed, stuck, or realizing that the way they’ve been getting through life just isn’t working anymore. They may be dealing with ADHD, anxiety, trauma, relationship stress, a difficult work environment, or a major life transition—or several of those things at once. I work especially well with people who want practical tools but also want to understand the “why” behind their patterns. Maybe you’re tired of overthinking everything, struggling to follow through even when you know what you need to do, questioning your own reactions, or trying to figure out what actually needs to change. You don’t need to have it neatly figured out before you come in. That’s part of the work we can do together.
Treatment methods
Cognitive Behavioral (CBT)
I use CBT in a way that is practical, flexible, and trauma-informed. We look at how your thoughts, emotions, behaviors, and nervous system responses are interacting, especially in the moments when you feel overwhelmed, stuck, reactive, or shut down. With ADHD, CBT may look less like challenging a thought on paper and more like breaking an overwhelming task into smaller steps, working around perfectionism, reducing avoidance, or figuring out why something that “should be easy” feels impossible to start. With trauma, I am careful not to treat every difficult thought as something that simply needs to be corrected. Sometimes a belief developed for a very good reason. We can look at whether it is still protecting you, whether it is getting in your way now, and what a more accurate or helpful response might be. The goal is not positive thinking. It is helping you understand your patterns, reduce the amount of power they have over you, and build strategies that actually work in your real life.
Psychodynamic
I use psychodynamic therapy to help clients understand where certain patterns came from and why they may still be showing up now. We may look at early relationships, family dynamics, attachment experiences, and the messages you learned about yourself and other people. The goal is not to spend every session focused on childhood. It is to notice when an old pattern is affecting a current reaction. For example, you may: *expect conflict *feel responsible for other people’s emotions *shut down when criticized *repeat relationship patterns you know are not working With trauma and ADHD, this can be especially helpful because not every struggle is simply a “bad habit” or distorted thought. Sometimes there is a long history behind why a response developed. I usually combine this work with more practical approaches, so we are not only understanding the pattern—we are also figuring out what to do differently with that insight in everyday life.
Trauma-Informed Care
I use trauma-informed care as a foundation for how I work, not just as a separate technique. That means I pay attention to how past experiences may be affecting your nervous system, relationships, sense of safety, and reactions in the present. In practice, this can include: *slowing down when something feels overwhelming *noticing triggers and body-based responses *helping you feel more in control of the pace of therapy *understanding behaviors as adaptations to your environment, not just "issues" to be "fixed." *building coping and regulation skills before going deeper I also try to avoid assuming that every difficult reaction needs to be pushed through or challenged immediately. Sometimes the first step is understanding why your system responds the way it does. The goal is to help you feel safer, more regulated, and more able to make choices in the present without being as controlled by past experiences.
Somatic
I use somatic and mind-body approaches to help the people I work with notice what is happening physically, not just emotionally. Sometimes the body reacts before we have words for what is going on. In some cases that can look like tension, restlessness, shutdown, racing heart, fatigue, or feeling constantly “on.” In practice, this can include: *noticing where stress shows up in the body *identifying physical cues that come before overwhelm *using grounding and breathing strategies (or, I may share some resources to help you explore this when you're more comfortable) *tracking changes in energy, tension, and activation *practicing ways to help the nervous system settle *building awareness of the connection between thoughts, emotions, and physical responses The goal is not to force relaxation. It is to help you become more aware of your own signals and develop ways to respond earlier, before stress or activation becomes harder to manage.
Location
Virtual sessions
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Licensed in
- CaliforniaLicense 99300