question: Although Stepped Care 2.0 is a new model, programming and principles are familiar to many. What is new, are the processes for system building and adjustment discussed in Chap. 10.1007/978-3-030-48055-4_6. Equipped with these processes many institutions are adopting variations of the model to suit their unique ecosystems. Specifically, post-secondary counselling centres across North America and publicly funded mental health care systems in Canadian provinces and territories are now implementing Stepped Care 2.0. A comprehensive case study, based on an amalgamation of implementation experiences, illustrates the co-design process, emphasizing strategies for working through conflict and ensuring maximum stakeholder buy-in.