This chapter reviews implementation of progress feedback in youth mental health settings using a “golden thread” approach, where feedback creates reinforcing loops of value across organizational levels. Progress feedback involves routinely collecting patient-reported outcomes, viewing feedback reports, and using this information to guide clinical decisions. While research demonstrates its effectiveness in reducing treatment dropout and improving symptoms, implementation of progress feedback remains complex due to the multiple stakeholders involved in youth mental health care. A detailed case study illustrates how progress feedback can surface informant discrepancies, facilitate difficult conversations, and promote shared understanding between youth and caregivers. The authors emphasize the importance of clinician openness to feedback and reaching an “aha moment,” where cognitive dissonance leads to meaningful clinical insights. While questions remain about optimal implementation metrics and what constitutes “good enough” use of progress feedback, this chapter concludes that successful implementation requires attention to patient, clinician, and system-level factors that influence how feedback transforms into improved mental health outcomes.