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The therapeutic community (TC) is an environmental intervention where principles of working together democratically can enhance self-agency. While availability of inpatient TCs within the UK National Health Service (NHS) has declined, shorter or alternative interventions using core TC approaches have shown promise in enacting change. The purpose of this paper is to report and reflect on the development and running of a pilot nano-TC.

Foundations Group was a 2-h TC group intervention set up and run within the NHS for 18 months in 2021–2022, and taking place on City Farm premises. The group was convened as part of the complex emotional needs service in a mental health NHS Trust in the South West of England. Over the study period, the group comprised 11 members, one peer member and three staff members.

The authors reflected on the TC stance of working democratically with a fluid hierarchy, taking a non-expert approach, and using support and challenge to enhance self-agency and belongingness. The authors have detailed the structure of the group session including use of community meetings, psychoeducation, creative sessions and reviews. Members took on roles within the group including chairing sessions.

This group was a novel service within the NHS Trust where it was conducted and may represent a standalone therapeutic group. The authors hope it will show that core TC principles can be applied in shorter interventions than have previously been used.

Mentalization-based treatment (MBT) is a psychotherapeutic approach that aims to increase mentalizing capacity. The purpose of this meta-ethnography was to synthesize the available qualitative literature on MBT to allow for a more thorough understanding of the lived experience of those who have undergone this therapy.

A systematic search of seven databases was carried out. The Critical Appraisal Skills Programme was used to appraise the papers suitable for inclusion. The data were synthesized using a meta-ethnographic approach in which the second-order constructs from each paper were translated and reinterpreted creating a line of argument synthesis.

A total of 11 studies were included in the meta-ethnography. Three overarching themes were identified within the included papers which outlined that participant experience of MBT consisted of three different developmental stages. Navigating the therapeutic process describes the participant’s experience of the therapeutic process of MBT. The processes of change in MBT outlined participant reports of mechanisms of change experienced in MBT. Mentalizing self and others described the experience of generalizing new knowledge and skills to the world outside of therapy and unveiled the impact that engaging in MBT had on participants.

This meta-ethnography offers new insights into how clients experience MBT as a therapeutic process and offers suggestions for implementation in clinical practice as well as areas of focus for research of this therapeutic approach.