Origin of the therapeutic tool All the Stars Above
A few years after the death of her mother and her own difficulties coping with this loss, Daisy Luiten, being a newly qualified art therapist at that time, met lots of people who had also had someone dear to them die. Out of these meetings, listening to the stories of people in mourning, she conceived the idea of helping people find a new way of living after the death of a loved one.

That's why Daisy developed the therapeutic tool All the Stars Above. Only two years after her first handmade edition, this tool was produced and released in Dutch, adapted for professional use and tested by therapists and counsellors.

Need of connection
All the Stars Above meets the desire of the next of kin to discuss the loss of their loved one. During the development of All the Stars Above Daisy talked with adolescents and adults, and also with a variety of therapists specialising in bereavement counselling. Petra Penning (a clinical child psychologist with an expertise in dealing with grief and loss suffered by children, adolescents and adults) suggested the idea of the aim of the therapeutic tool. In her work with families, she experienced a great need for people to connect with each other after a loss. This connection can now be facilitated by participating in All the Stars Above.

In the mean time All the Stars Above is a well known therapeutic tool. It has won two awards and has been successfully received by therapists and counselors globally.

Background information on All the Stars Above
Information about the background to All the Stars Above (the most important aspects of the development) is comprehensively described in the booklet 'Background information', which you can find enclosed with the game. The text on this website is limited.

Art therapy
Art therapy distinguishes itself from other forms of counseling by allowing clients to express themselves using art, in the form of drawing, painting or sculpture.
The main focus in art therapy is the process of creation rather than the final product. Clients are encouraged to use their own imagination and artistic expression to explore feelings, ideas and issues evoked by the art-making process.

The therapeutic tool ‘All the Stars Above’, can be seen as the creative vehicle. Art expression is optional.

Coping with a loss
When a loved one dies
It is very painful when a loved one dies. The world of the next of kin is turned upside down completely. There will be grief, confusion and, perhaps, anger. These feelings won't disappear by themselves and strength, courage and lots of hard work are required to learn to cope with the loss. Every individual has their own way of coping and does this at their own rate.

Communication about loss
Adults are often more able to verbalise their feelings than children and adolescents after a loss. This does not mean that the feelings of grief and mourning for children and adolescents are less intense. In fact the opposite is true. From the moment someone is able to love another person, they are also able to miss them. Children and adolescents do not always use words to express themselves. More often, they do this in other ways such as playing and drawing.

All the Stars Above makes it easier for young people as well as adults to communicate about the loss. It opens opportunities to talk and also encourages other means of communication such as drawing. It is recommended to play this therapeutic board game in the presence of a therapist, as intense feelings may surface that require assistance to deal with. Supervision will provide this support for those involved.

Tasks during mourning
J.W. Worden distinguishes four tasks of mourning:
1 Accepting the reality of the loss
2 Experiencing the pain or emotional aspects of the loss
3 Adjusting to an environment in which the deceased is missing
4 Relocating the person within one’s life and finding ways to memorialise the person.
(Worden, 2001)
If these tasks are not pursued, further personal growth and development can be obstructed. By using All the Stars Above you invite participants to work on these tasks in an active way.

All the Stars Above emphasizes the reality of the loss by talking about the dying process and the funeral. The pain and emotional aspects of the loss are dealt with in the category ‘Feelings'. In general, the way the questions are formulated will also directly appeal to emotions.

All the Stars Above is in line with recent literature
Apart from the mourning tasks All the Stars Above is in line with recent literature:
- Families co-create a story around the death or loss and make sense of it (Family meaning making perspective, J. Nadeau)
- Clients are invited to share their own stories and they give meaning to the loss (Narratives and Meaning making perspective, Robert Neimeyer).
- Clients are not only invited to share about the loss and what happened to them, they are also invited to talk about restoration activities in their personal daily life
(Dual process theory, Stroebe and Schut).

All the Stars Above contains topical events
All the Stars Above contains different categories of questions, one of them is 'dying' to direct at what happened. Some causes of death raise their own specific questions. Therefore extra cards are supplied for instance in case of a disease, coma, accident, suicide or murder.

All the Stars Above also takes care of current events that have changed the lives of next of kin drastically. Extra questions have been added about dying in a war situation, dying during military service, being killed in natural disasters (Katrina, the Tsunami, Haiti) and dying after terrorism (think of 9-11).

These extra cards are supplied in the back of the card tray. The therapist can use them when the specifice cause of death is applicable. The asterics and dots at the bottom of the playing cards refer to the cause of death (explanation can be found in the manual, page 14).

Therapeutic tool in the appearance of a board game
During the development of the therapeutic tool it was important to consider what a communication-promoting tool should look like. To involve every client attending a therapeutic session (family members, groups and individuals of all ages) a board game seemed to be the appropriate appearance for the therapeutic tool.

Aspects of the therapeutic tool designed to facilitate communication:
- it is non-competitive, because being opponents does not invite co-operation.
- it offers a safe and comfortable environment in which the participants are given time and space to tell their story.
- there is the opportunity for the players to react to each other.
- it is interesting and offers variety, thereby keeping the participants' attention.

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