Depending on what you want to do.. a sampler, a design from a photograph, a design of your own, etc. there are a variety of different methods. This isn´t a very easy question to answer. :-)
There are several computer programs out there to help - PC Stitch, Stitch-A-Photo, Pattern Maker Software, Pattern Maker Cross Stitch Clipart, and I´m sure there are more. These software programs will help and provide you small images that can be used in your designs.
If you are trying to do a sampler of sorts you could just start with a book of drawn thread and cross stitch stitches and design your own on a piece of graph paper.

I would think the ´simplified´ version is to find a software program that provides you with some of the functionality you are looking for.

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