I typically design each element against a blank background. This simplifies the process, focusses my eye on the element, and makes the boundary of the element clear.
But after designing each element, it’s important to plug it in to the overall image. This checks that the design is coming together well.
Blue-Luna-Moon-Context, a photo by Carmen CS on Flickr.
Prayer: Father, help her and her caregivers to focus on each element of her treatment, while keeping the larger context of her life in mind.