Upon release, Preacher's Daughter was met with acclaim from music critics, with praise towards its storytelling and songwriting, and Cain's vocal performance.

[2] Two years later, after leaving her religious family home in Florida, she began her gender transition process and started writing her debut studio album.

[9] Before the idea of Preacher's Daughter, Cain was working on a different concept album "about angels and stuff"; she stated that she was under "LSD psychosis withdrawals".

[11] She declared that "a week or two" after watching the 1991 film Thelma & Louise, she wrote "Thoroughfare" and the album "shifted into a new gear", and was inspired to see "where [the story] was truly going".

[3][13] Preacher's Daughter is a concept album inspired by Cain's own struggles with culture and religion, but centered on the fictional character of the same name, a girl who suffered abuse from her father and runs away from her Christian family and community.

[3] The overall lyrical themes of the album include transgenerational trauma, toxic relationships, and cultist Christianity,[16] and some of the content is a criticism to the American Dream.

[9][17] Writing for Vox, Emily St. James found the album's characterization similar to Truman Capote's In Cold Blood and to the works of Flannery O'Connor.

[18] Cain stated that Preacher's Daughter was the first chapter of the story, with an intention to write a series of novels, while directing and starring in an accompanying film.

[16][13] Beats Per Minute's Tom Williams drew comparisons between the lyrics of "Western Nights" and Ultraviolence, a 2014 album by American singer-songwriter Lana Del Rey.

[23][13] On "Hard Times", Cain longs for the love of a distant father who perpetuated sexual abuse to her, and pleads him, "Tell me a story about how it ends, where you're still the good guy.

[15] "Sun Bleached Flies", the penultimate song on Preacher's Daughter, finds the character reflecting from beyond the grave; she later recalls the third track: "I'm still praying for that house in Nebraska.

[15] Preacher's Daughter was described variously by critics as an Americana,[11] folk,[25] ethereal,[26] goth-pop,[27] and dark ambient[13] album with perceived influences from slowcore, heartland rock, gospel,[13] industrial, noise, and horror-electronica.

[13] Music critics, including Williams and Pitchfork's Evan Rytlewski, drew comparisons between the song's sound and the early works of American singer-songwriter Taylor Swift, specifically her 2008 album Fearless and its 2010 follow-up Speak Now.

[33] The cover artwork of the album depicts Cain sitting below a painting of Jesus Christ, wearing a vintage white dress and heels.

[15] In an interview with Nylon, Cain stated that she wanted the cover to be "a little creepy, like an eerie photograph found under your grandmother's bed of a relative she never told you about".

[34] Promotional visuals for tracks from the album feature grainy shots of empty cabins and churches with American flags, with lights turned on, ceiling fans running,[15] and crucifixes on wood-panelled walls.

[43] As part of Vevo's DSCVR Artists To Watch 2023 series, the singer recorded live performances for the album tracks "A House in Nebraska" and "Thoroughfare".

[56] Writing for Clash, Oshen Douglas McCormick found that Preacher's Daughter marked "a stark growth of stylistic confidence" following Inbred.

The critic also wrote that Cain's musical journey reached "a new height" with Preacher's Daughter, and described it as "a truly realised culmination of style and composition".

[27] Jessie Atkinson of Gigwise wrote that the album has the potential to have a Carrie-sized cultural impact, comparing its terrifying moments to the 1974 novel by Stephen King and their ages when their works were published.

[59] Our Culture Mag's Konstantinos Pappis felt that Preacher's Daughter started to build Cain's legacy, and it managed to reach a wider scope.

[61] In a less favorable review, Pitchfork writer Evan Rytlewski marked "Ptolemaea" as a standout, but noted a disconnect between the singer's "provocative public image and the rigid composure of [the] songs".