Intergenerational patterns in emotion socialization: findings from an emotion coaching program in Appalachia

Introduction

Families in Appalachia are commonly characterized by tight-knit kinship networks and multigenerational families, with strong cultural values of resilience, collectivism, tradition, and self-sufficiency (Keefe and Curtin, 2012; Manoogian et al., 2015; Roberson et al., 2023). Individuals in this region may also disproportionately experience poverty, low educational attainment, health disparities, and limited access to healthcare, with stigma serving as a barrier to seeking behavioral healthcare services (Nardella, 2022; Studts et al., 2020). This unique sociocultural context and the associated intergenerational family dynamics can shape emotion socialization practices, or the ways caregivers respond to and discuss adolescent emotions (Eisenberg, 2020; Girod et al., 2025). Emotion socialization practices are influential to adolescent socioemotional adjustment and increasingly addressed in parenting programs (England-Mason et al., 2023), thus it is critical to consider these sociocultural factors when delivering parenting interventions to Appalachian families. Understanding how emotion socialization unfolds across generations within the cultural context of Appalachia is needed to provide culturally sensitive behavioral healthcare in this community.

Emotion socialization

Emotion socialization refers to the process by which caregivers communicate with adolescents about emotions, which shapes an adolescent's ability to understand, express, and regulate their emotions in accordance with their goals and social context (Eisenberg, 2020; Eisenberg et al., 1998). Morris et al. (2007) tripartite model delineates several avenues of emotion socialization, such as observation of caregiver emotion modeling, emotion-related parenting practices (e.g., caregiver-adolescent communication about emotions, responses to adolescent emotional displays), and the overall emotional climate of the family. Importantly, developmental context shapes how caregivers enact emotion socialization. Adolescence is characterized by biological and neurological developments that can increase the intensity of emotional experiences but also increase capacity for emotion regulation (Hollenstein and Lougheed, 2013). Adolescents also seek more independence from parents and rely on friends for emotional support compared to childhood (Branje, 2018; Miller-Slough and Dunsmore, 2016). Nonetheless, adolescents continue to benefit from caregiver scaffolding of emotion regulation. Given these developmental shifts, caregivers may be less prescriptive or directive in their emotion socialization approach with adolescents compared to children to encourage adolescents' independent emotion regulation (Breaux et al., 2022; Miller-Slough and Dunsmore, 2016).

In addition to developmental context, caregiver emotion socialization is shaped by several other factors, such as caregiver characteristics, adolescent characteristics, situational context, and cultural norms (Eisenberg, 2020). Notably, a caregiver's childhood experiences influence how they approach caregiving with their own children. Caregivers may internalize and later model behaviors they were exposed to by their own caregivers (Bandura, 1977; Belsky and Jaffee, 2015), such that how caregivers respond to their children's emotions are in part based on how caregivers were socialized to express and regulate their emotions in childhood.

Caregivers' childhood experiences also impact their meta-emotion philosophy, or their beliefs and attitudes about children's emotions and their role in scaffolding adolescent emotion regulation (Eisenberg et al., 1998; Gottman et al., 1996). For instance, parents with an emotion-dismissing philosophy view adolescents' emotions as dangerous and needing to be suppressed, leading to caregivers deploying punitive or critical responses during emotion-centered discussions, or deciding not to engage in the discussion at all (Gottman et al., 1996). Along these lines, Leerkes et al. (2020) reported that mothers' experiences of non-supportive emotion socialization from their caregivers corresponded to less supportive reactions to their children's emotions. Research demonstrates that caregivers who experienced dismissing or avoidant responses to their emotional expressions by caregivers in childhood, such as walking away when they were in distress, found child negative emotions more discomforting than caregivers who experienced attentive and responsive caregivers (Girod et al., 2025; Lempres et al., 2026).

Comparatively, emotion coaching is a meta-emotion philosophy in which parents view their child's emotions as an opportunity for teaching and closeness; thus, parents socialize their child's emotions by being emotionally responsive, conveying acceptance of emotions, assisting children with identifying their emotions, and facilitating problem-solving if needed (Gottman et al., 1996). Caregivers who had emotionally responsive caregivers during childhood exhibited greater rates of maternal sensitivity to child negative emotions and distress, allowing them to respond to their children in more attentive ways (Girod et al., 2025). Similar results were found in fathers who experienced greater levels of affection from caregivers during childhood. More specifically, fathers shown greater affection in childhood engaged in higher rates of positive parenting behaviors, such as responsiveness (Madden et al., 2015).

Associations with adolescent outcomes

A growing body of literature shows links between caregiver strategies of emotion socialization and child and adolescent outcomes, including emotion regulation, internalizing symptoms, and externalizing symptoms (Eisenberg, 2020). Cross-sectional and longitudinal data demonstrate a link between caregivers' unsupportive responses to their adolescent's emotions and both poorer adolescent emotion regulation (Hale and Zeman, 2023; Miller-Slough and Dunsmore, 2019) and higher adolescent internalizing and externalizing symptoms (Klimes-Dougan et al., 2007). Conversely, caregivers' supportive responses to adolescent emotions were associated with lower internalizing and externalizing problems (Klimes-Dougan et al., 2007). Adolescent regulation of sadness or worry has been found to mediate the relation between caregiver's unsupportive responses to their adolescent's emotions and adolescent internalizing symptoms (Hale and Zeman, 2023). Overall, research suggests that caregivers' responses to adolescents' emotions play an important role in adolescent emotional and behavioral adjustment, such that these emotion-related parenting practices are increasingly addressed in parenting programs (England-Mason et al., 2023).

Emotion coaching parenting program

Tuning in to Teens (TINT) is a universal prevention parenting program focused on building adolescent emotional intelligence through addressing caregiver emotion socialization practices (Havighurst et al., 2015). Based on the meta-emotion philosophy framework noted above (Gottman et al., 1996), TINT focuses on building caregivers' recognition of their own emotion socialization and improving their emotion coaching responses with their adolescents. Intended for caregivers of adolescents aged 10-17 years, the program includes six to eight sessions in which caregivers learn about adolescent emotional development, identify their own beliefs about emotions, and consider how these beliefs impact their approach to their adolescent's emotions. Caregivers learn and practice the five steps of emotion coaching, such as building their awareness of the adolescent's emotion and considering it as a teaching opportunity, practicing emotional acceptance, assisting with labeling the emotion, and scaffolding problem-solving if needed. Facilitators and caregivers also discuss how emotion socialization unfolded in their families of origin. Caregivers then discuss ways to integrate emotion coaching into their responses to their adolescent's fear, sadness, and anger and learn about ways to support their own emotion regulation during challenging parenting moments (Kehoe et al., 2013; Havighurst et al., 2022).

Empirical support for this program demonstrated that caregivers receiving TINT reported reductions in emotion dismissing practices, decreased difficulties with emotional awareness, and improvements in adolescent anxiety and depression symptoms (Havighurst et al., 2015; Kehoe et al., 2013). Treatment effects on adolescent internalizing symptoms were mediated by improvements in caregiver emotion regulation (Kehoe et al., 2020). Though this program was designed to be implemented in-person, positive treatment effects have been found with online implementations of its parallel program for school-age children, Tuning in to Kids (TiK; Havighurst et al., 2013). Parents receiving Tuning in to Kids Online (TIKOL) reported increases in caregiver emotion coaching, decreases in caregiver emotion dismissing, and improvements in their children's behavioral problems and anxiety (Burkhardt et al., 2024; Havighurst et al., 2024).

This program has been examined in several cultural contexts to explore possible adaptations to improve cultural sensitivity of program implementation. Havighurst et al. (2022) identified beneficial cultural adaptations to program delivery for families in China, Germany, Iran, and Turkey. Facilitators considered each culture's emotional language and slowly increased the use of self-disclosure to build trust among caregivers. German and Iranian caregivers often found the scripted role plays to be unrealistic; thus, facilitators shifted to unscripted role plays. Iranian caregivers often reported experiencing their children's emotions as manipulative and viewed emotion coaching as being permissive, leading facilitators to spend more time exploring caregivers' meta-emotion philosophy in the context of their family of origin. Iranian caregivers also grappled with how to integrate emotion coaching with the caregiving, and at a times interference, of extended family members (e.g., grandparents). With Chinese caregivers, facilitators allowed more time to discuss foundational emotion-related parenting concepts and found caregivers responded better to paired work than group work. Overall, this study shows the benefit of considering sociocultural context when implementing emotion coaching interventions, which is further elaborated below as it relates to Appalachia as a sociocultural context.

Appalachia as a sociocultural context

Appalachia stretches from southern New York to northern Mississippi, containing a rich cultural heritage and community network. Kinship networks are often strong sources of purpose and support for Appalachian families, with multiple generations of family members commonly opting to live in the same area and being involved in caregiving (Keefe and Curtin, 2012; Stephens, 2005). Kin networks may include individuals outside of one's family, such as neighbors, close friends, and other community members (Stephens, 2005). Importantly, collectivist ideals permeate Appalachian culture, making caring for others and serving as the “village” for children and adolescents in the community an integral part of daily life that evokes immense pride (Bowden Templeton et al., 2008; Keefe and Curtin, 2012). For instance, individuals within a tight-knit kinship network might mutually provide food, services, money, information, transportation, and monitoring of child and adolescent activities. Kin networks also rely on one another to care for children, elderly individuals, and those with elevated medical needs (Bowden Templeton et al., 2008; Keefe and Curtin, 2012; Manoogian et al., 2015; Stephens, 2005).

Accordingly, the responsibility for the safety, health, and wellbeing of oneself and one's family tends to remain within the kinship network, exemplifying the self-sufficiency of the Appalachian community (Stephens, 2005). Other common values in Appalachian culture include determination, hard work, and resilience (Keefe and Curtin, 2012; Stephens, 2005). Consequently, caregivers and other important adults in children's lives strive to impart these values onto children in hopes of raising respectful, responsible, successful, and happy adults (Bowden Templeton et al., 2008). Outside of community participation in childrearing, mothers are often primarily responsible for childcare and home maintenance in Appalachian communities, which can be a strong source of pride, identity, and enjoyment (Keefe and Curtin, 2012; Manoogian et al., 2015; Stephens, 2005). Overall, the mutual care provided by Appalachian families and kinship networks, especially as it relates to childrearing, exemplifies the connectedness of the community.

Notably, Appalachian culture is also shaped by a history of exploitation and health disparities (Cattell-Gordon, 1990). The rise and fall of the coal mining industry in the Appalachian region left lasting, systemic impacts on the economic, environmental, and physical health of Appalachians (Nardella, 2022; Zipper and Skousen, 2021). The opioid epidemic strongly impacted Appalachian communities, leading to disproportionately higher rates of substance abuse and poverty compared to national averages (Gibbons et al., 2020; Thomas and Brossoie, 2019). Moreover, individuals from Appalachia face harmful stereotypes and prejudice, contributing to feelings of isolation and marginalization (Nardella, 2022). These historical events have contributed to medical mistrust and a mistrust of “outsiders,” leading Appalachians to rely on trusted in-group members in the community (Newland, 2010; Owens et al., 2007). Appalachia faces health disparities in chronic illnesses (Meit et al., 2019) and shortage of healthcare providers and clinics, necessitating long travel to receive medical care (Bican et al., 2025). Lastly, stigma surrounding mental health and receiving mental health services is present in Appalachia, with a cultural norm of relying on trusted family members and religious leaders for support (Keefe, 1986; Thomas and Brossoie, 2019). All in all, understanding the rich cultural tapestry of Appalachian communities-namely, the cultural values surrounding caregiving, family, strong community ties, and the historical context of exploitation and marginalization-is essential to providing culturally sensitive parenting programs.

Parenting programs in Appalachia

There is a small body of research that examines the intersection of Appalachian culture and parenting programs. Studts et al. (2020) interviewed Appalachian parents and child service providers to determine their preferences for parenting interventions. Results indicated there was a clear desire for parenting intervention programs, particularly those for school-age children and older, as parents noted that parenting interventions were extremely limited in their region and often restricted to early childhood. Parents preferred programs led by trusted local community health workers who were parents themselves to mitigate parents' concerns of judgement and stigma by out-group members. Some parents indicated a preference for groups as it conferred social support by fellow parents, whereas other parents preferred individual parenting supports due to confidentiality and stigma concerns. There was also a preference for neutral and non-threatening environments that families already frequented, such as churches, schools, and libraries, again due to concerns of confidentiality and stigma.

Further, Hernandez et al. (2020) implemented an emotion-focused parenting program, Tuning in to Kids (Havighurst et al., 2013), in rural Appalachia with parents of school-age children. Their findings offered insight into the facilitator-parent interactions that promoted parental engagement. Qualitative analysis of program sessions indicated when parents had space to discuss their expertise on their children and their faith, facilitators were better able to gain parents' trust. It was also critical that facilitators recognized the cultural value of obedience in children, such that facilitators presented emotion coaching parenting skills as additional tools to incorporate into their existing parenting repertoire. It was also observed that parents offered each other reassurance and peer support, potentially reflecting traditional Appalachian values of kinship and community. Lastly, the parents also seemed to appreciate when the facilitator offered anecdotes and advice from the perspective of a parent rather than a psychologist, or when facilitators referenced their own connection to the local community. Consistent with previous findings regarding the importance of provider trust in Appalachia, having a facilitator who is a member of the community and who can relate to the parents on a personal level may help allay potential distrust or dismissal of outsiders (Hastings and Cohn, 2013; Thomas and Brossoie, 2019) and may also reduce worries about being judged by mental health professionals (Owens et al., 2007). Taken together, implementing parenting programs in rural Appalachia merits consideration of parents' values, methods of building trust, and methods of reducing stigma.

Present study

Research demonstrates that emotion socialization is impactful for child and adolescent psychosocial adjustment, such that it is increasingly addressed in emotion-focused parenting programs (England-Mason et al., 2023; Kehoe et al., 2013). However, these emotion-related parenting practices are transmitted across generations of a family and context (Leerkes et al., 2020), making it paramount to consider the broader family system, as well as cultural norms regarding parenting and emotion expression, when implementing such programs (Havighurst et al., 2022). Appalachia is a sociocultural context characterized by tight-knit multigenerational families, cultural values of resiliency and independence, and a strong commitment to the community (Keefe and Curtin, 2012). Appalachia also holds a long-lasting history of health disparities, mental health stigma, and medical mistrust (Bican et al., 2025; Thomas and Brossoie, 2019). There is a small literature base on the consideration of sociocultural context when implementing parenting groups in Appalachia (Hernandez et al., 2020; Studts et al., 2020), yet much remains to be discovered. Thus, the present study conducted a qualitative analysis of dialogue amongst Central Appalachian caregivers receiving a virtual emotion-focused parenting program (TINT), regarding the intergenerational transmission of emotion-related parenting practices.

Method

Participants

Forty-five caregivers (M = 44.72 years old, SD = 11.45) of adolescents (M = 13.62 years old, SD = 1.92) in Central Appalachia participated in the TINT parenting program. The current sample was comprised of biological mothers (57.8%), biological fathers (6.7%), stepmothers (4.4%), adoptive mothers (4.4%), grandmothers (6.7%), and aunts (2.2%). The current sample identified themselves as African American (2.2%), European American (68.9%), American Indian (2.2%), Native Hawaiian or Pacific Islander (2.2%), and those who identified with other racial or ethnic identities (8.9%). Caregiver education ranged from a high school degree (2.2%) to some college coursework (15.6%), a college degree (37.8%), or a graduate degree (28.9%). Household annual income ranged from $17,000 to $175,000 (M = 84,053.00, SD = 45,603.43), with the average household income for this area being $54,854 (United States Census Bureau, 2025). Some of the families in the sample received food stamps (8.9%), social security/disability (15.6%), federal health insurance (22.2%), and free or reduced lunch (24.4%). Some families had recently moved into the Appalachian region, while others had lived in Appalachia for generations (range = 0-18 generations, M = 3.25, SD = 3.81). As TINT is designed for caregivers of adolescent- or teen-aged children, caregivers had to be the primary caregiver for a child aged 10-17 years old to be included in the study. TINT is designed to be implemented as an intervention or prevention program; as such, there were no inclusion or exclusion criteria based on mental health diagnoses.

Procedure

The current study was approved by the East Tennessee State University Institutional Review Board (IRB# c0922.19e). Researchers recruited participants through the distribution of flyers in local community spaces, schools, community programs, healthcare agencies, and courts. Prior to enrollment, research staff contacted potential participants to troubleshoot any technological issues related to attendance, as the program was delivered virtually via Zoom.

Participants provided informed consent prior to the first group session. The program was delivered via Zoom in five group iterations from fall 2022 to spring 2024. The program was offered virtually to improve accessibility, given the aforementioned barriers to behavioral healthcare in Appalachia (Bican et al., 2025; Thomas and Brossoie, 2019). At the beginning and end of the program, participants completed online questionnaires as part of the larger study. Program delivery ranged from 6-8 weekly sessions, with each session length ranging from 1-1.5 h, and was structured according to the TINT manual. No adaptations were made to the TINT manual in program delivery. Participants were taught course material through psychoeducation, group exercises, discussion time, and video demonstrations. Group facilitators included the principal investigator, who is a clinical psychologist certified to run TINT groups, and two clinical psychology graduate students. Participants received no financial compensation for attendance. Sessions were recorded, transcribed, and reviewed for accuracy for later coding and analysis.

Data analytic plan

The current study used an inductive thematic analysis approach to identify themes in caregiver dialogue related to the intergenerational transmission of emotion-related parenting practices and sociocultural context (Braun and Clarke, 2006). This inductive approach allowed codes and themes to be developed from the data rather than being predetermined. Prior to analyses, full transcripts from all TINT sessions were searched for content relevant to the current study, as the larger program approaches subjects beyond the focus of the present study. The guidelines for initial data combing included extracting any transcripts that related to (1) how emotions were parented when the caregivers were children, (2) what the caregivers might have observed about their own caregiver's emotions or parenting practices, and (3) additional information about the family dynamic the participant grew up in that was not previously captured in the other guidelines. The coding team consisted of the study's principal investigator, two graduate student research assistants, and one undergraduate research assistant. Prior to the start of coding, the principal investigator trained research assistants in the coding process.

During the first phase of coding, coders familiarized themselves with the data by independently reviewing the selected transcripts in full. Researchers were encouraged to review transcripts multiple times to ensure familiarity. After this process, researchers independently generated a preliminary list of themes observed from the transcripts. The coding team then met to compare initial themes, making note of commonalities across the preliminary lists. The coding team then repeated this process, reviewing the transcripts and re-generating their independent list of themes. The coders identified overlapping themes from these lists, which were consolidated into broader conceptual themes.

Using this theme list, researchers then returned to the data to independently assign themes to transcript excerpts. The coding team continued to meet until consensus was reached on theme assignment. In the final phase of coding, researchers met to discuss and identify representative excerpts for each theme to illustrate the patterns observed in the caregivers' responses.

Reflexivity statement

This research was conducted in the Developmental Psychopathology Lab at East Tennessee State University, which focuses on translating research on youth mental health risk and protective factors into clinical practice with children and families. At the time this study was conducted, all authors were residents of Appalachia. Two authors hold multigenerational roots in the region, whereas three authors are more recent residents who moved to the area for educational training. All authors are trained in psychology, with a focus on emotional and relational processes within parent-adolescent relationships. Two of the authors have clinical experience working with families in Appalachia. At the time of writing, the research team included individuals at multiple stages of training, from undergraduate to doctoral-level students, as well as a licensed clinical psychologist. The research team includes individuals who identify as women and who largely come from middle-class backgrounds. Authors identified as White and Hispanic. One author is a parent.

Results

The results from the inductive thematic analyses revealed several themes regarding emotion-related parenting practices. Themes included (1) non-tolerance of emotions in caregiver's childhood, (2) caregiver's childhood shaped by survival or adversity, (3) generational differences with grandparent caregivers, (4) caregiver emotion suppression or limited emotional awareness, (5) cycle breaking, (6) caregivers learning to allow space for adolescents' emotional needs, and (7) generational differences in being a teenager. Descriptions of these themes and representative excerpts are presented below. In some instances, caregiver or adolescent demographic information was not available and this detail will be indicated in the excerpt.

Non-tolerance of emotions in caregiver's childhood

Several caregivers noted that emotions were not discussed in their family when they were growing up. Some caregivers recalled an emotional climate that did not support emotional expression, modeled through the actions of the caregivers' parents, and ultimately internalized by the caregivers. Other caregivers observed dynamics in which preserving relational harmony was prioritized over individual emotion expression.

“I don't ever remember discussing emotions with my family as a child... I can't ever remember sitting down and anyone telling me that it was okay, or it wasn't. I think it was more just through the actions of my parents and others that were influential to me as a child... I didn't see them discussing it, so I didn't discuss it.”

45 year old father of 11 year old daughter

“When I was a kid, I wasn't really encouraged to express a lot of emotion. My parents just wanted to be, like, calm and quiet, you know, so I didn't like upset them.”

Mother [age unknown] of a 13-year-old son

In some instances, this climate was shaped through the parents' active discouragement of emotion expressivity and redirection.

“Growing up the way that I did, it was like if you had a big emotion, it was wrong, and you should deal with it and go to your room and not talk about it.”

Mother of 15-year-old son, 13-year-old son, 11-year-old daughter and a 10-year-old son

“Well, that is how I grew up.......If I was playing ball and I got hurt, you know. Get up, wipe it off, carry on... the dismissive part is the style I grew up with.”

44-year-old father of 13-year-old daughter

Caregiver's childhood shaped by survival or adversity

Another theme that emerged is caregivers experiencing adversity in childhood that contributed to a family climate of emotion suppression and strained communication. In these contexts, economic and familial stressors appeared to place a strain on family bandwidth and resources in a manner that had downstream effects on caregiver-child communication about emotions.

“I grew up uh rather poor. We had an outhouse didn't have water inside the house…And so that additional stress, you know, growing up as a teenager...if you disagree because you wanted to have some autonomy and choices that you wanted to make...it was dealt with very aggressively verbally.”

Mother [age unknown] of a 14-year-old daughter

“There was a whole lot of dysfunction within the family...People would disappear for a while, and then come back. And then it was like, Well, what happened? And we just...didn't talk about it, and nobody knew why they were gone, and why they were back...they were just back, and we just pretended like everything was good.”

45-year- old father of 11-year-old daughter

However, caregivers also recognized the ways in which their parents attempted to “make do” with what they had, reflecting cultural values of resiliency and self-sufficiency in the face of economic adversity.

“Our parents, raised in rural Alabama um, in the you know they were both born in the 40s, so life was so much different....they didn't have great role models you know, alcoholic parents and abusive parents to one another...and they did the best they could with what they had. And in a lot of ways they tried to make life better for us.”

Mother [age unknown] of 15-year-old daughter and 14-year-old son

Generational differences with grandparent caregivers

The strong presence of grandparents was reflected in caregivers' responses, either in the traditional grandparent role or as custodial grandparents. Custodial grandparents are increasingly common in Appalachian communities (Beatty et al., 2023), which presents a different caregiving context. Some caregivers noted how the generational norms and values of their grandparents shaped their approach to emotions.

“I was raised by people who are old...when I was born, my grandfather was 60 years old...learning to deal with emotions...just wasn't something I was really taught, considering the people who taught me...[were the] same people who was raising kids in the forties… It [was] more black and white...It's either wrong or right...there was no in between. If you make a decision, stick with [it]. Apology is a sign of weakness. But I was also taught that anger is actually not a bad thing. It is a good thing, it was put there for us to protect ourselves...It goes back to protecting your food, protecting your kids, protecting your immediate area, you know this is my territory.”

Father [age unknown; child age/gender unknown]

Other caregivers noted how their childhood experiences with grandparents shaped their parenting approach, and at times represented a disconnect with their partner's views when raising their own children. The excerpt below also exemplifies the close nature of extended families in Appalachia, both geographically and relationally.

“I lived with my mom and dad, but they worked all the time, so my grandparents raised me around the same age…I grew up on a farm and with my cousins, and we fished and done all these crazy things, and got our tails wore out if something was awry…but my husband was raised totally different. And so we butt heads on [how] we raise our kids a lot.”

45-year-old mother of 13-year-old girl

Caregiver emotion suppression or limited emotional awareness

When reflecting on their childhood experiences, some caregivers observed how their childhood experiences contributed to patterns of emotion suppression or limited emotional awareness as an adult.

“If it [a conversation] gets intense, we just won't talk about it and hope it goes away, which is extremely unhealthy.”

45-year-old father of 11-year-old daughter

“I've realized that I don't tolerate emotional extremes very well. And I think that's part of what is making my interactions with my kid difficult.... His last screaming match, [he] was like smashing things in the living room. It reminded me of my dad, and I kind of like shut down and kind of went dead to him. When I‘ve been trying to do the emotional coaching I've been having a really hard time, because I like I can‘t. I don't notice emotions, like I don't know to see emotions at all.”

Mother [age unknown] of a 13-year-old son

“For a long time that's been my MO is just we just don't talk. It's not that we talk, you know, abusively, or anything. It's just, we just don't.”

45-year-old father of 11-year-old daughter

Caregivers noted ways in which these patterns were forged out of adversity and contributed to their resiliency, a core cultural value in Appalachia, but acknowledged that it came at a cost.

“I rely on myself. Because that's all I had. Um, so that makes you a strong person and a resilient person. But I still to this day I mean crying is, I don't feel that it's an emotion. I don't feel that it's wrong, but I cannot cry in front of people.”

Mother [age unknown] of 15-year-old daughter and 14-year-old son

Cycle breaking

When caregivers discussed the ways in which their emotions were not encouraged or ways in which their childhood was shaped by adversity, they often went on to discuss how they are forging new paths with their children to “break the cycle.”

“I have struggled with it, too, because I wasn't raised in a house where we talked about our feelings, but it's something that I want my kids to feel comfortable doing.”

Mother of 15-year-old son, 13-year-old son,11-year-old daughter and a 10-year-old son

“I want to break that cycle, and you know that's what I'm trying to do.”

Mother [age unknown] of a 14-year-old daughter

“[After a conflict between mother and daughter] And so the following morning in the car, I apologized. I said, you know … I got out of control... I raised my voice to you. I don't want to be doing the same thing my parents did with me... Sometimes I'm ignorant...I don't have the answers...We'll just have to find them together.”

Mother [age unknown] of a 14-year-old daughter

These recollections sometimes involved painful memories of growing up that led caregivers to fiercely and intentionally parent their children in a different direction.

“My parents when I was growing up, I mean my mom like.. If I was in [a heated] conversation with her like that...if you...question here, you just got smacked...right through the face...that's not something I wanna do...I want [my daughter] to be able to think for herself.”

Mother [age unknown] of a 14-year-old daughter

“I tell them [my children] all the time I hear my mother coming out, which I think a lot of us experience...but I try very, very hard to not be like that...I could probably count on 2 hands how many times she told me in the 52 years...that she loved me. I tell my children- people probably think I'm crazy because I tell them so much, but that's because I didn't get that. I don't ever want them to doubt that I love them, and that they are wanted and... accepted for who they are, and that they... are valued for everything about them.”

Mother [age unknown] of 15-year-old daughter and 14-year-old son

“I know it comes straight from the way that my mother raised me...I can either let this destroy me or I could use it as a stepping stone, and make the next generation different and better. So, I try really hard not to devalue my children like that, because, because I felt like I was very devalued.”

Mother [age unknown] of 15-year-old daughter and 14 year-old son

These recollections demonstrated the caregivers' value of their adolescents' autonomy, desire to convey love and acceptance, and respect for their adolescents as individuals. Moreover, these reflections highlighted how resilience assisted caregivers in charting a new course in their emotion-related parenting practices.

Caregivers learning to allow space for adolescents' emotional needs

Caregivers reflected on the ways that they allow space for their children's emotions in the family context.

“I really try to let my kids express themselves to a degree. I mean, we're not gonna let it get out of control.”

45-year-old mother of 13-year-old girl

Allowing space came up in the context of how caregivers gave their adolescents space to feel their emotions privately before addressing them in conversation.

“He has to be able to come down emotionally before we can discuss, or before he can hear or reason...that is an experience I never had. And it's not the way I experienced...parenting my older kids. But for this kiddo, you know, that really has to happen before he can make any kind of emotional sense out of anything.”

52-year-old mother of 10-year-old son

“He's upset, not mad, just give him a minute, and then go back and talk to him.”

Mother [age unknown] of 15-year-old son, 13-year-old son,11-year-old daughter and a 10-year-old son

Gender differences in parenting adolescent emotions

Gendered patterns of emotion expression came up often, with caregivers noting the constraints placed on boys' and men's emotion expression. There was a consistent theme of the gendered norm of emotion suppression for boys.

“Knowing my dad, my stepdad, my current fiancé...a lot of men think that it's not okay for them to talk about how they feel. So, raising boys, I think they don't think that they‘re manly if they say they're upset.”

Mother [age unknown] of 15-year-old son, 13-year-old son,11-year-old daughter and a 10-year-old son

“When I was little…I was in church group or scouts, or something. We're having a foot race and…I lost the foot race…For some reason I started crying, just bawling my eyes out, and the time the adults really didn't know what to do. They just kind of put me to the side, and it's not like I haven't lost the race before. But you know, boys, aren't supposed to cry, and there's a bunch of other guys there. They...didn't know what to do. So it's really [an] odd and awkward situation.”

Father [age unknown] of a 14 year old daughter

There were also reflections on how vulnerable emotions (e.g., sadness, worry) were channeled in anger.

“Real men didn't cry, you know, we didn't feel sad or didn't show emotions, you know. As far as like when we're upset…[it] kind of translated to more anger internally.”

Father [age unknown, child age/gender unknown]

In some instances, these cultural norms also reflected how boys were situated within the broader family context and the sense of responsibility they had toward other family members.

“There was this unwritten rule that as I was...the only male, and...I needed to protect my sisters. I needed to not express fear…I didn't have a right to be emotional that I needed to keep those things together...I can remember both of my half-sisters having, you know, these huge emotional outbursts and then my parents, reacting emotionally and it just feeling like this real big, chaotic scene…I need to be the one that doesn't create this...I just need to be quiet and let them have their emotions.”

45-year-old father of 11-year-old daughter

Generational differences in being a teenager

In considering changes across generations, a few caregivers noted the unique experiences, and sometimes challenges, of raising adolescents in modern times. The generational differences between caregivers and their adolescents represented ways in which these two generations have different childhood experiences.

“The reality now is totally different than when I was 8 or 7 or 12....We didn't have a cellular phone with us. We didn't have Internet. We didn't have any of the...things that the kids nowadays have.”

40-year-old mother of 12-year-old son

“These teenagers are different and they‘re learning a lot more at a younger age than we did... I stayed naive probably till my twenties. These children...they're more woke…They are more aware of a lot more than we were at their age.”

51-year-old mother of 14-year-old daughter

In other instances, this disconnect represented a cultural shift in childhood experiences and values.

“I think about the different generations. You know, I'm 44 years old. I grew up in the eighties and nineties. We didn't get participation trophies award. [You got something] because you did something well, not just because you were there.”

44-year-old father of 13-year-old girl

In sum, the qualitative analysis indicated themes regarding how caregiver's emotions were parented, how these emotion-related parenting practices unfolded across contexts of adversity, generational status, and gender. Caregivers also noted ways in which these emotion-related parenting practices shaped how they manage their emotions in adulthood and how they parent their adolescents' emotions. Some of the themes wove together in such a manner that told a story of families in Appalachia experiencing hardship in ways that may have limited family emotion expression in childhood and contributed to emotional avoidance, but also built resilience, in adulthood. This resilience then fueled the next generation of caregivers to break the cycle of emotional suppression and create space for emotion when parenting their adolescents.

Discussion

Emotion-focused parenting programs are an effective tool to support adaptive emotion-related parenting practices and adolescent psychosocial adjustment (Kehoe et al., 2013; England-Mason et al., 2023). Emotion-related parenting practices are rooted in cultural norms regarding family and emotion expression, which are passed down across generations (Eisenberg, 2020; Leerkes et al., 2020). The present study examined themes in emotion-related parenting practices across generations of families in Appalachia, a cultural context characterized by strong kinship networks, resilience, and adversity. These themes were observed in the context of caregivers participating in an emotion-focused parenting program (TINT).

The themes from this qualitative analysis told a story of how caregivers' emotions were parented in their family of origin, which in turn shaped caregivers' approach to their own emotions and those of their children in adulthood. Caregivers described a family climate in which there was limited space for emotion expression, such that they were taught, directly or indirectly, to suppress their emotions or to handle them privately. Appalachia displays many characteristics of a collectivistic culture, in which group harmony is prioritized over individual expression (Bowden Templeton et al., 2008; Keefe and Curtin, 2012), which can translate to cultural norms of suppressing emotions that could disrupt group harmony (Havighurst et al., 2022). This messaging about emotion may reflect underlying cultural values of determination and resilience (Keefe and Curtin, 2012; Stephens, 2005), such as persevering through challenging feelings or circumstances. This theme illustrates the salience of family of origin experiences, which are addressed in emotion coaching parenting programs as a tool to reflect on one's own parenting approach. The parenting that caregivers received as children informs how they go on to approach parenting, and this intergenerational dynamic is situated within sociocultural context. Acknowledging the sociocultural norms that shape family of origin experiences can assist behavioral healthcare providers in connecting with Appalachian caregivers in a culturally sensitive manner and mitigate the risk of medical mistrust.

It is also possible that a family norm of emotion suppression may have been a protective or contextually appropriate response in the face of adversity. Several caregivers noted ways in which their family experienced adversity or hardship, either in the context of economic distress or instability in the family home. This theme aligned with prior research on the hardships faced in Appalachian communities, such as high rates of poverty, substance abuse, and health disparities (Gibbons et al., 2020; Nardella, 2022). Within the context of adversity, emotion expression may have been perceived as not helping with or even adding to family strain or conflict and therefore discouraged by caregivers. Additionally, caregivers may have a lower capacity to adequately and empathetically respond to their child's emotions during times of high stress, ultimately teaching children to keep emotions to themselves to preserve their caregivers' capacity. Therefore, being emotionally guarded may serve as a survival response in the context of adversity. Nonetheless, caregivers also recognized how these emotion-related parenting practices could be understood within the broader context of the family climate and how their parents “did the best they could with what they had”, exemplifying the values of self-sufficiency, determination, and care for one's kin that permeate Appalachian culture (Keefe and Curtin, 2012; Stephens, 2005). This sociocultural backdrop can assist behavioral healthcare providers in working with Appalachian caregivers as they process family of origin experiences and implementing emotion coaching with their adolescents, as emotion coaching may be at odds with previous family experiences that were shaped by adverse circumstances.

Experiencing adversity contributed to caregivers' resiliency, which is a core value in Appalachian communities (Keefe and Curtin, 2012; Stephens, 2005), but may also contribute to patterns of emotional avoidance in adulthood. Again, emotional avoidance may represent a contextually appropriate response for survival in childhood but may no longer match their current circumstances as an adult. From a trauma-informed perspective, experiencing strong negative emotions in the context of parenting may be triggering (Isobel et al., 2019), as one caregiver noted that witnessing her son's anger expression brought her back to similar exchanges with her father as a child and led her to withdraw from the interaction. Caregivers acknowledged that patterns of emotional suppression or avoidance were problematic but also spoke to how being more emotionally expressive as an adult was challenging in the context of the emotion socialization messages they received as children. In this light, supporting caregivers' emotion regulation is paramount when implementing an emotion coaching parenting program in Appalachian communities, as the program sessions may elicit strong negative emotions that stem from childhood experiences.

This dynamic of emotion suppression was particularly pronounced in the context of gender, as one theme illustrated ways in which men and boys were expected to be more emotionally reserved and, in some instances, allow more emotional space and vulnerability for female relatives. This theme is consistent with extant research on gendered emotion socialization, in which boys are socialized to express dominant emotions (e.g., anger) whereas girls are socialized to express vulnerable emotions (e.g., sadness and worry) and to be more emotionally expressive in general (Chaplin, 2015). These gendered lines of emotion expression align with the more traditional gender roles, which are embedded in Appalachian culture but also present in many communities outside of Appalachia (McHenry-Sorber and Swisher, 2020).

In reflecting on how their childhood experiences shaped their patterns of emotion expression as adults, caregivers commented on their intentional efforts of “breaking the cycle” of the intergenerational transmission of emotion dismissing practices and creating space for their adolescent's emotions. Caregiver descriptions of cycle-breaking took many forms, such as making efforts to repair with their children after a disagreement, findings ways to de-escalate heated exchanges between caregivers and adolescents, providing emotional validation and support, as well as conveying respect and acceptance for who their children are. Efforts to make space for their adolescents' emotions may be further amplified by current mainstream conversations about the gentle parenting movement and positive parenting practices, which many caregivers may consume via digital media (Pezalla and Davidson, 2024; Walters, 2024). This theme of cycle-breaking also mirrored the literature on ways that Appalachian communities work to break other intergenerational patterns that can unfold in their families, such as substance abuse and poverty (Nardella, 2022; Sedney et al., 2026). Armed with the knowledge that this is a familiar hill that many Appalachian families climb, behavioral healthcare providers can better situate themselves to support Appalachian caregivers as they address intergenerational patterns in parenting practices, with emotion coaching as one tool that can support cycle-breaking.

Findings also illustrated how emotion-related parenting practices were shaped by generational context, particularly regarding the role of grandparents. Caregivers discussed how their grandparents responded to their emotions in childhood, whether grandparents served as additional parental figures or as a custodial parent figure. The grandparents' generational norms for emotion expression and parenting played a role in how their grandparents responded to their emotions, which translated to limited discussion of emotion and strict behavioral expectations in some instances. However, there were also messages about how emotions, such as anger, can help protect one's family, community, and property. This message regarding how anger can guide one to protect others aligns with the deep connection to the community and land that exists in Appalachia culture (Thomas and Brossoie, 2019). Understanding the role of grandparent caregivers is particularly salient in Appalachia, given the prominent role of extended family members in Appalachian families (Keefe and Curtin, 2012). There are also higher rates of grandparent-headed households in Appalachian counties compared to non-Appalachia counties (Beatty et al., 2023), and these grandparents have unique parenting needs. Custodial grandparents face complex stressors, such as the financial and physical stressors of caring for their grandchildren that may not have been anticipated. Custodial grandparents might also have to navigate challenging dynamics that may exist with their adult children, particularly when their caregiving arrangement exists in the context of parental substance abuse or incarceration (Hansen et al., 2022; Hatcher et al., 2018). Acknowledging these different generational norms in parenting and emotions, as well as the potential strain that grandparent caregivers may experience, can better tailor an emotion coaching parenting programs to multigenerational families and custodial grandparents.

Lastly, caregivers spoke to a generational divide regarding their childhood experiences and those of their adolescents, commenting on the unique experiences and struggles of today's adolescents. Caregivers referenced technological differences (e.g., access to the internet, smartphones) as well as their adolescents being more informed and aware than they were as children. This divide could pose a unique challenge in the context of emotion-related parenting practices, as their adolescents are navigating stressors that caregivers may not be able to relate to based on their own childhood and are grappling with how to approach the matter as a caregiver. Additionally, caregivers' support networks when they were children may have been much smaller, more tight-knit, and limited to family, neighbors, and close friends. Comparatively, their adolescents have access to a wider range of support online, and may even use technology for emotion expression and regulation (Hollenstein and Faulkner, 2024) Thus, caregivers may feel like they are competing with technology when attempting connect with their children, which was not an experience they had as children. A generational disconnect was also evidenced in some instances, such as the mention of today's adolescents receiving “participation trophies” rather than earning accomplishments, which may be representative of the cultural value of hard work and self-sufficiency held by caregivers in Appalachia (Keefe and Curtin, 2012; Stephens, 2005). Taken together, there were a multitude of intergenerational themes relevant to emotion-related parenting practices, which translate to clinical implications when implementing emotion-focused parenting programs.

Clinical implications

The results of the present study offer clinical implications for behavioral healthcare providers working with families in Appalachia, particularly those implementing parenting programs. First, understanding the family system and kinship network is critical, with regards to who is in the family home and who is providing caregiving. There may be a prominent presence of extended kin members, grandparents who are heavily involved in caregiving, or custodial grandparents. Moreover, emotion-related parenting practices can vary across generations. Consideration of these factors network can aid providers in determining which caregiving figures in the child's life may benefit most from participation in parenting interventions, as well as understand how generational context may inform emotion-related parenting practices occurring in the home.

Second, it is worthwhile to spend time understanding the family's values regarding parenting and emotions, which are culturally informed. Understanding what the caregiver grew up learning about parenting emotions, as well as their approach to their adolescent's emotions, will greatly inform how to approach these topics in a culturally sensitive manner within an emotion-focused parenting program. Active reflection on these topics can guide the caregiver as they navigate their current caregiver-adolescent dynamics and respond to their adolescent's emotions, as these responses are informed by their childhood experiences. Reflecting on the caregiver's beliefs and experiences with emotion may also highlight ways in which the caregiver's approach conflicts with the intervention. Understanding the caregiver's perspective may assist clinicians in integrating the caregiver's experiences with the tenets of the intervention, which may build rapport and aid caregivers in utilizing the program skills in a manner that is genuine to them because their perspective is heard and respected (Hernandez et al., 2020). This reciprocal process between the clinician and caregiver is particularly important in the context of the marginalization and medical mistrust that exists in Appalachian communities (Thomas and Brossoie, 2019).

Lastly, it is critical to take a trauma-informed approach and support caregivers who are often cycle-breakers. Caregivers may be processing their childhood experiences and growing in their own emotion regulation skills while simultaneously supporting their adolescent's emotion regulation development, which is a heavy mental load. Finding ways to support the caregivers', as well as the adolescents', emotional competencies is critical to the health of the whole family. Additionally, acknowledging the difficulty caregivers face in attempting to break cycles may improve the caregiver's relationship with the provider, as well as enhance the caregiver's motivation to utilize emotion-related parenting practices. Finally, improved understanding of caregivers' personal values and emotion experiences, as well as their broader sociocultural context, may improve providers' empathy and understanding of caregivers' current emotion-related parenting practices that may differ from the emotion coaching intervention.

Strengths, limitations, and future directions

The present study adds to the literature by representing the perspectives of caregivers in Appalachia, a community and a region that is underrepresented in the literature. The qualitative methodology offers rich and nuanced information that would not be captured by quantitative methods. The study examined intergenerational family dynamics that shape emotion-related parenting practices, offering a broader familial context that is often missed in studies that focus solely on caregiver-adolescent dyads. These findings also translate to clinical implications for behavioral healthcare providers working with Appalachian families, offering guidance on how to discuss emotion-related parenting practices in a culturally sensitive manner, as these practices are informed by cultural values regarding emotion and parenting. These considerations are critical considering the barriers to behavioral healthcare in Appalachia, such as being in a medically underserved region with pronounced health disparities (Bican et al., 2025; Meit et al., 2019), experiences of medical mistrust, and the stigma regarding behavioral healthcare (Nardella, 2022; Thomas and Brossoie, 2019). These findings also point to how to incorporate a trauma-informed perspective to understand (1) how adversity shapes emotion-related parenting practices across generations and (2) support caregivers in reshaping these dynamics as they socialize adolescent emotion regulation.

There are also limitations that point to directions for future research. The present study had a small sample size and participants were predominately mothers, which limits the generalizability of findings. Future research would benefit from examining the wide range of caregivers that are present in family systems, particularly given the extended kinship networks that exist in Appalachia (Keefe and Curtin, 2012; Stephens, 2005). In the current sample, there was considerable variability in family socioeconomic status. Socioeconomic status affects a family's resources and caregiver bandwidth, all of which affects parenting and the family environment. It would be beneficial to replicate this study with a larger sample size to be able to further investigate these research question in different socioeconomic contexts. Given the diverse subcultures that exist throughout Appalachia (Denham, 2016), it is also important to examine these research questions in other Appalachian regions. The sample was also predominately European American and reported household incomes that were slightly higher than regional averages, limiting generalizability of findings. Examining these research questions with a sample that contain greater diversity in racial/ethnic background and socioeconomic status is warranted to represent all voices in Appalachian communities. Lastly, all participants chose to join a study about emotion-focused parenting programs, therefore it is possible that there was a self-selection bias in which this sample was not fully representative of caregivers in Appalachia (Costigan and Cox, 2001). There may also have been social desirability factors that affected how and what participants shared during group sessions.

Conclusions

The present study offers insights on emotion-related parenting practices across generations of families in Appalachia and how this intersects with emotion-focused parenting programs. Caregivers noted how early adversity shaped how their emotions were parented in childhood, which fostered resiliency but also contributed to emotional avoidance in adulthood. Caregivers also noted cycle-breaking behaviors they now implement in their emotion-related parenting practices with their adolescents. There were generational and gender differences in emotion-related parenting practices. Understanding these experiences within the sociocultural context of Appalachia can assist behavioral healthcare providers in implementing emotion-focused parenting programs with cultural sensitivity.

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Footnotes

Edited by: Dorthe Kirkegaard Thomsen, Aarhus University, Denmark

Reviewed by: Sylvia Chu Lin, The University of Melbourne, Australia

Briana Williams, East Carolina University, United States