Karen frequently collaborates with Philip Glass and has led performances of Orphée (New York, Germany), conducted the premiere of his Les Enfants terribles (Spoleto Festival, USA), and made her BBC Proms debut in August 2017 appearing with Anoushka Shankar in the first-ever live performance of Passages, Glass’s collaboration with Ravi Shankar. She was honoured with a Grammy Award for her recorded performance of the work at the Metropolitan Opera in 2019.

She appears regularly as guest conductor with numerous orchestras throughout Europe and SE Asia, and has worked with youth orchestras in Linz, Cologne and Dortmund. Last summer she led a programme at the American Institute of Musical Studies (AIMS) in Graz, Austria.

She has led productions at Deutsche Opera Berlin, Frankfurt Opera, New York City Opera (touring company), Opera Australia, Royal Danish Theatre, San Diego Opera, San Francisco Opera and Volksoper Wien, among many others, in performances of Death in Venice, Pelléas et Mélisande, Susannah, The Merry Widow, Pagliacci, Cavalleria rusticana, Boris Godunov, Tosca, Otello and Lohengrin, among others.

Notable engagements elsewhere: Music Director/Chief Conductor of the Staatsoper Hannover, 2011–16: Lady Macbeth of Mtsensk, Die Meistersinger von Nürnberg, Il trittico, Caligula, Jenufa, Das Rheingold, Die Walküre, Candide and Der Freischütz; Rigoletto and Akhnaten (Metropolitan Opera); Die Zauberflöte (Lyrica Opera Chicago), Wonderful Town (Norwegian National Opera), Dracula (Royal Swedish Opera), Dead Man Walking (WNO).