How do you design your forum styles?

[kobescoresagain]

Okay, I am going to make one of these this summer (haha it will probably take me that long). I wanted to know how everyone designed theirs. Did you do it in photoshop and slice it and then add content or what? I have downloaded the design package and have a good idea of how to change things around, but I would like any information on what Ishould know or expect while creating it. Thakns