I think they're easy peasy! You do HAVE to stabilize them or you'd seriously want to kill somebody in about 5 minutes, and the older, more worn out crappy t-shirt works the best. But I find the motif thing is no big deal. It is what it is. It's supposed to be a mishmash of colors and themes. I have always tried to find a frame fabric that fits the theme, even though it may not coordinate with any of the shirts. So for instance, I made a t-shirt for an Iowa State grad (my brother-in-law... we forgive him) and the fabric was BRIGHT red with BRIGHT yellow stars. This was not a quilt that was going to sit quietly in a corner!
Now, water color quilts are a different story. I practically needed counseling by the time I had that sucker done.