Professional competition both within the personal problems jurisdiction and from outside it (e.g., insurance and accounting) continued to shape the availability and quality of mental health care to the present day. Yet the landscape has changed – social stigmas against those seeking mental health care seem to have waned. Yet, the cost and lack of access to care has also led to alternative, mostly non-professional, approaches to dealing with personal problems. Grounded on Abbott’s work, we consider some of these dynamics in a time of technological changes and increasing challenges to professions and their expertise.