Individual Placement and Support is an evidence-based method created to support people with mental health problems reach vocational goals. The IPS-Y fidelity scale builds on IPS principles to reinforce a focus on young adults and their need for educational supports. Through 13 focus group interviews, this study explored practitioners’ considerations of program fidelity in relation to cultural and contextual issues regarding IPS-Y in Sweden. Findings suggest that various welfare contexts and organizational challenges impact service delivery. Practitioners were driven to better meet the individual needs of young adults, intentionally adapting their method and approach.