I've done both. I have used patterns for paper and foundation piecing. Also, I have used patterns for applique. However, I also will take a pattern that is too small for my needs and reblock it for a larger quilt. I have also taken blocks that are orphaned and used them for scrap block quilts without a pattern. I am also currently working on a picture of a quilt I saw on the Clotilde website that seems to be simple enough to make from the picture without the pattern. I think patterns are good for inspiration but I usually do my own thing with it unless it is too complicated for me to figure out with basic math skills. Also, my landscape quilt didn't have a pattern. I made it from a memory.