This chapter provides an overview of key concepts and theoretical perspectives used in the anthology and points out fundamental challenges in the practice of professional welfare. ‘Competence’ and ‘knowledge’ often have different meanings, and there is a need for increased awareness of the understanding of these concepts. This chapter highlights how the managerial discretion, learning, system blindness, power executing and paradoxes may cause tensions and how these in turn may inhibit the realization of required changes. Internal or external job recruitment may have an impact on managers’ freedom to act. To raise the quality and competence within the professional welfare services, it is necessary to be aware of the unique and multi-faceted challenges in the field.