It doesn't have to. In essence, fanily constellation is about positioning the client within their family, however that may be, so they can experience it from a distance and feel what it does to them when seen like that. The client positions their own members.

Then, they can suggest changes to the co stellation that would make them feel better or resolve their tension. These changes are left open to the client. The therapist should not intervene and just reflect what they see so the client can see the picture better and from an even more objective standpoint.