Flower Essence Therapy in Juvenile Shelters in Costa Rica


Kristin Holthuis Dr. Kristin Holthuis
Dr. Holthuis in her office
Photo: Edgar Mora


Flower Essences in Cost Rica:
A Government Funded Institutional Project

Although flower essences are widely known and easily accessible in Costa Rica, Dr. Kristin Holthuis reported on a major breakthrough with the Costa Rican government supporting the inclusion of flower essence therapy in shelters through PANI (Patronato Nacional de Infancia), the National Institute for Child Protection Services in Costa Rica. A pilot project was approved in 2016, and Dr. Holthuis sent a report of the results to the Flower Essence Society Spanish-Language Symposium, held in June 2017.

Project Justification:
The health effects of adverse childhood experiences

According to the first ACE (Adverse Childhood Experiences) study, a large study by Kaiser Permanente and the USA Centers for Disease Control, there is a substantial negative impact of traumas experienced in childhood on their physical and emotional health throughout life.

The ACE study takes into account the following situations, which are common in the lives of young people living in state shelters:

  1. Severe emotional abuse
  2. Severe physical abuse
  3. Sexual abuse
  4. Physical negligence
  5. Emotional neglect
  6. Substance abuse in the family
  7. Violence against the mother
  8. Family mental illness
  9. Family in prison
  10. Separation of parents

This first ACE study, and many studies afterwards, showed that there is a direct relationship between adverse events in childhood and health problems throughout life, as illustrated in this chart:

ACE chart
The studies showed a strong relationship between early childhood trauma (which are prevalent for children living in institutions of Child Protection Services) and physical and mental health problems, including risky behavior, in adult life.

For instance, people who self-identify with at least six adverse experiences in childhood are at greater risk of:

  • Decrease in average life expectancy (up to 20 years)
  • A 4600% increased risk of dying from heroin overdose
  • An increased risk for cardiovascular diseases, addictions, depression, anxiety, mental health illnesses, attempted suicide, violence, morbid obesity, respiratory problems, gastric ulcer, cancer, autoimmune diseases, amongst others.

Dr. Holthuis believes that the effective and timely approach to deal with the impact of emotional trauma should be an absolute priority in public health, throughout the health care system, in schools, in child protection institutions, in households, NGOs and in organized communities.

After more than ten years’ experiences with the use of Flower Essences and Energy Psychology modalities for many physical and emotional situations, Dr. Holthuis recommends including these therapies as an integrative part of interventions for treating emotional upset and multiple consequences of trauma for children, adolescents and adults.

Objectives and Goals of the Pilot Project

  • Empower children and adolescents in the management of their emotions through complementary and integrative therapies (Energy Psychology modalities and Flower Essence therapy).
  • Develop skills in the caregivers through individual teaching of Energy Psychology techniques and flower essence therapy for effective implementation in themselves and the children.
  • Apply personalized flower essence therapy for 4 months to a subset of children in the shelters, identified by the staff in need of assistance.
  • Measure the effectiveness, through objective data and interviews, of the administration of flower essence therapies in the children and adolescents.
  • Support caregivers as they apply Energy Psychology strategies and flower essence therapy with foster children.
  • Provide staff with self-care strategies.
  • Provide foster homes with Flower Essence Therapy for crisis situations.
  • More than 50% of the juveniles living in the foster homes in the Limon province receive integrative care through trained staff.

Five-Flower Formula


The complementary and integrative therapies used in the project

  • Various natural strategies for self-care for caregivers (like life style changes, easy physical exercises, easy diet changes)
  • Flower essence therapy - customized for 40 juveniles - emergency accessible to all foster homes and
  • Energy Psychology Tools: EFT (Emotional Freedom Techniques) and TTT (Trauma Tapping Technique) and Energy Medicine exercises

Results and testimonials of the project


Flower essences for emergencies


85% of shelter staff in the pilot project used flower essences for emergency situations.


For acute situations, the children in the pilot project received a combination of Five-Flower Formula (Rescue Remedy) with Arnica. This combination was selected with the intention to elicit calm and stability in situations of shock, stress, panic, anxiety, aggression, trauma, pain, conflicts and other situations causing acute stress.

Dr. Holthuis reported that 85% of shelter staff in the pilot project used flower essences for emergency situations.

In interviews with the caregivers and mental health professionals they reported on their experiences using flower essences with children in emergency situations:

  • "The boys and girls calm down."
  • In some cases they used it on a daily basis with the most affected juveniles (juveniles with depression, a lot of aggression or suicidal ideas).
  • When in crisis, they sometimes did not remember that they had access to emergency Flower Essence Therapy.
  • It was also used by the caregivers for themselves in times of high stress.
  • All participants observed positive effects in most of the cases where they applied the emergency formula.

Personalized Flower Essence Therapy


90% of the 33 children reported feeling improvement.
personal formula

Therapy outcomes were measured by three report forms: one was completed by the caregiver observing the child, the other in collaboration with the child, and the third through interviews with the children. The data were collected before the start of the therapy, 2 and 4 months later.

  • 40 children between 8 and 16 years old received a blend of personalized flower Essence Therapy during the time of the pilot project in 2016.
  • 33 children were administrated personalized flower essences during 4 month period in 2016.
  • 90% of the 33 children reported feeling improvement.
  • 50% said during the interviews that the flower essences met (or exceeded) all of their expectations.

In order to prepare the customized formulas, the following information was taken into account:

  1. An interview with the child
  2. The application of two forms: PROPS and CROPS (See here for details.)
  3. A report from the caseworker in charge of the child.

Testimonials of some of the children and adolescents who took flower essence therapy for 3-4 months


A 10-year-old boy

This boy took flower essences for four months for guilt, sadness, anxiety from painful memories, irritability, hyper vigilance, frequent conflicts, problems with exams at school.

I am not trash.

Formula 1: Red Chestnut, Pine, Gentian, Mariposa Lily, Rescue, Delph (PHI essences)
Formula 2: Mariposa Lily, Sunflower, Rock Rose, Elm, Larch, Delph

Here is what he had to say about his experience:

“I am ten years old. I have been living in this shelter for 6 years. When I was separated from my Mom I felt that I was a piece of trash for the world, but a young lady told me that I was not a piece of trash for the world because I had some gifts and could become a professional. But I didn’t believe her.

“I took some flower drops and that started to do me good and to help me. Then the lady asked me, “Are you still feeling like a piece of trash?” And I said to her that since I took those flower drops I began to feel that I am not that anymore because I can become a professional if I want to and if I make the effort. I want to have a good job because now I know that I am not a piece of trash for the world. I can do things, I have a value and I can be of good use to my Mom in all that she might need in the future. Thank you very much.”

Listen to his testimony (in Spanish) here


An 8-year-old girl who lived in shelters most of her life

This girl was reported for many outbursts of anger. She also mentioned that she felt sadness, anxiety, irritability, insomnia and concentration problems.

Formula 1:
Impatiens, Gentian, Larch, Mimulus, YES, Mariposa Lily, Rescue, Delph
Formula 2: Red Chestnut, Walnut, Mariposa Lily, Gentian, YES, Impatiens, Delph

Interview after 4 months:
"Everything feels different: I don’t feel angry anymore, I feel calm and I can pay attention in class. I don’t feel sad anymore, the essences met all my expectations

An 11-year-old boy, in a shelter from 2 years of age

His self-reported situation before taking flower essences was: sadness, laziness to study, anxiety, hyperactivity, insomnia, recurrent fights in foster home and misbehavior at school.

Formula 1:
Holly, Impatiens, Elm, Walnut, Larch, Delph, and Hornbeam
Formula 2: Mariposa Lily, Impatiens, Rescue, Walnut, Sunflower and Dogwood.

Interview after 4 months:
"The drops helped me a lot. I behave better in class and I do not fight anymore. I feel calmer. I do better on exams. I had no expectations but they helped me a lot.

A 15-year-old teenage mother

This young person reported a family history involving suicide by her father, and her stepfather dying in an accident. At 13 years old she was raped by a group of boys and then suffered another rape by an unknown older man. She got pregnant at the age of 14. Her one-year-old son is frequently ill.

She reports feeling shy, hopeless, fearful and insecure. She suffers from insomnia and frequent nightmares. She says "I want to die, I only live for my son," showing a lot of sadness and hopelessness, crying a lot and says she feels often intimidated by the other girls.

I feel hopeless

Formula 1: Rescue, Sweet Chestnut, Gentian, Larch, Centaury, Mimulus, Red Chestnut
Formula 2: Sunflower, Centaury, Red Chestnut, Mimulus, Gentian, Holly, Larch

Dr. Holthuis noted many changes during an interview after one month. She entered the interview room smiling broadly, and appeared different physically than she had one month earlier, to the point of almost not being recognizable.

She says: "I do not know what you put in these drops but I feel superb; I do not cry any more. I put limits on the other girls; I do not run away from situations, I fight for my rights. It seems that everything flows. I do not worry so much any more. I feel happy, and that feels so strange.”

After two months, there was much anger for everything that happened and the formula was successfully adjusted.

Energy Psychology Modalities

Dr. Holthuis combines Energy Psychology techniques with the use of flower essence therapy. In this project, two “tapping techniques” from the field of Energy Psychology were included: EFT (Emotional Freedom Techniques) and TTT (Trauma Tapping Technique). Follow this link to read more about the use of Energy Psychology techniques in the project.

A New Expanded Program Approved in 2017

After receiving positive results from the use of flower essences with foster residents in a pilot project in 2016 in the Limon province of Costa Rica, Dr. Holthuis’s program is currently being implemented in 2017 in 29 of the shelters in Costa Rica that are directly managed by the PANI.

On June 22, 2017, Dr. Holthuis signed an agreement with PANI for an expanded program. 130 caregivers and mental health staff of the PANI are currently being trained in various methods for managing emotions in the after effects of trauma.

contract signing

Signing of the contract, with PANI’s lawyer, Omar Badilla
Photo: Diana Badilla Solórzano

All the shelters included in the program are being provided with emergency flower essence therapy. There will be individualized treatment for 60 juveniles, with another 45 in personal consultation.

caregivers in power pose

Caregivers during training doing the “power-pose” in the 2017
Photo: July Bustamante

The recipients from the 2017 project, currently in the state of implementation, are given an enriched flower essence formula for emergency situations, comprised of:
- Five Flower Formula (Rescue Remedy)
- Arnica
- Echinacea
- Thousand Roses (Monochaetum vulcanicum), a Costa Rican flower essence made from a small magenta flower which is the first flower blossoming on a volcano after a disaster of an eruption has occurred.

Thousand Roses flower

Thousand roses (Monochaetum vulcanicum).
Photo: Kristin Holthuis

If you'd like more information about the pilot project, ongoing treatment in the shelters, or to donate to help make future projects possible, please contact Dr. Kristin Holthuis by email: medicinadeluz@gmail.com.

Kristin Holthuis, MD, is a Dutch Family Physician who has lived and worked in Costa Rica for over 20 years. She has integrated Flower Essences and Energy Psychology for her holistic medical practice. As a trainer in various Energy Psychology modalities (See ACEP Association for Comprehensive Energy Psychology). She loves to inspire health care professionals to make healthcare more human, sacred, personalized and efficient by integrating complementary and integrative treatments. She is the founding Director of the IIPE: International Institute for Energy Psychology.

This article was adapted from a presentation created for the Flower Essence Society Spanish-Language Symposium, June 2017. Special thanks to Lori Hops, Ph.D., licensed psychologist and Reiki master, for reviewing earlier drafts of this article.


[ About FES | Online Repertory |Class Offerings | Research & Case Studies | Interviews and Articles]
[ What's New | Publications | Membership | Find a Practitioner | Members' Pages | Home ]


P.O. Box 459, Nevada City, CA  95959
800-736-9222 (US & Canada)
tel: 530-265-9163 


Copyright © by the Flower Essence Society.
All rights reserved.